Organization
CHIROPRACTIC PERFORMANCE CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARA JEAN CUPERUS D.C. (OWNER)
(320) 255-0961
Entity
Organization
Contact information
Practice address
2380 TROOP DRIVE, SUTIE 201, SARTELL, MN 56377-4637
(320) 255-0961
(320) 258-4001
Mailing address
2380 TROOP DRIVE, SUITE 201, SARTELL, MN 56377-4637
(320) 255-0961
(320) 258-4001
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
786
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331J2CH
BCBS - CLINIC #
MN
01
—
332J9KL
BCBS INDIVIDUAL #
MN
01
—
350002734
MEDICARE INDIVIDUAL #
MN
05
—
777641100
—
MN
01
—
965001033012
PREFERRED ONE
MN
01
—
C03940
MEIDCARE CLINIC #
MN
Enumeration date
07/17/2007
Last updated
01/04/2017
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