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Organization
WILLMAR CHIROPRACTIC CLINIC P.A.
Active
Organization
WILLMAR CHIROPRACTIC CLINIC P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG MATTHEW LEIS D.C. (PRESIDENT)
(320) 235-7347
Entity
Organization
Contact information
Practice address
1950 19TH AVE SW, WILLMAR, MN 56201-4925
(320) 235-7347
(320) 222-2826
Mailing address
1950 19TH AVE SW, WILLMAR, MN 56201-4925
(320) 235-7347
(320) 222-2826
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2839
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
725528400
—
MN
Enumeration date
07/15/2010
Last updated
07/15/2010
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