Organization
FAMILY CHIROPRACTIC CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD MONTAGNE (DC)
(218) 485-4451
Entity
Organization
Contact information
Practice address
501 ARROWHEAD LN, MOOSE LAKE, MN 55767-7707
(218) 485-4451
(218) 485-4451
Mailing address
PO BOX 649, MOOSE LAKE, MN 55767-0649
(218) 485-4451
(218) 485-4451
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2623
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231151
ACN
MN
05
—
332528800
—
MN
01
—
35900015922
MEDICARE RAILROAD
MN
01
—
60715HE
BCBS
MN
Enumeration date
10/16/2013
Last updated
08/16/2017
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