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Organization
HENNING CHIROPRACTIC CLINIC, P.A.
Active
Organization
HENNING CHIROPRACTIC CLINIC, P.A.
Active
Other names
Henning Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DAVID MORTENSON DC (DOCTOR OF CHIROPRACTIC/OWNER)
(218) 548-2447
Entity
Organization
Contact information
Practice address
801 INMAN ST., HENNING, MN 56551
(218) 548-2447
(218) 548-2448
Mailing address
P.O. BOX 134, 801 INMAN ST.,, HENNING, MN 56551
(218) 548-2447
(218) 548-2448
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3941
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1334085-00
—
MN
01
—
36D46HE
BCBS
MN
Enumeration date
02/26/2010
Last updated
02/26/2010
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