Organization
MITTENESS CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MITTENESS (OWNER)
(320) 563-4130
Entity
Organization
Contact information
Practice address
702 HIGHWAY 75 S, WHEATON, MN 56296-9415
(320) 563-4130
Mailing address
702 HIGHWAY 75 S, WHEATON, MN 56296-9415
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1696
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3C935MI
BLUE CROSS BLUE SHIELD
MN
Enumeration date
06/27/2007
Last updated
08/22/2020
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