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Organization
PRINCETON BACK AND NECK CLINIC PA
Active
Organization
PRINCETON BACK AND NECK CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN CRAIG VANHOOSER D.C. (PRESIDENT)
(763) 631-2225
Entity
Organization
Contact information
Practice address
209 RUM RIVER DR N, SUITE 2, PRINCETON, MN 55371-1609
(763) 631-2225
Mailing address
209 RUM RIVER DR N, SUITE 2, PRINCETON, MN 55371-1609
(763) 631-2225
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1677
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350004181
MEDICARE PTAN
MN
Enumeration date
05/09/2012
Last updated
05/09/2012
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