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Organization
IHS MIDWEST PC
Active
Organization
IHS MIDWEST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER PAUL MASSOGLIA SR. DC (PRESIDENT)
(651) 334-1290
Entity
Organization
Contact information
Practice address
211 HIGHWAY 25 S, MONTICELLO, MN 55362-9306
(651) 334-1290
(763) 295-9116
Mailing address
450 FORD RD, UNIT 101, ST LOUIS PARK, MN 55426-1058
(651) 334-1290
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
MN
261QM2500X
Medical Specialty Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
06/22/2006
Last updated
10/24/2014
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