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Organization

MOSENG CHIROPRACTIC PLLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BROCK J MADSEN DC (OWNER)
(320) 269-7135
Entity
Organization

Contact information

Practice address
525 LEGION DR STE 1, MONTEVIDEO, MN 56265-1723
(320) 269-7135
(320) 269-7583
Mailing address
525 LEGION DR STE 1, MONTEVIDEO, MN 56265-1723
(320) 269-7135
(320) 269-7583

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
6138
MN
111NS0005X
Sports Physician Chiropractor
Primary
2209
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
647527200
MN
Enumeration date
12/21/2017
Last updated
01/02/2018
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