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Organization

CANNON VALLEY CHIROPRACTIC,LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MATTHEW AUGUST MAKI D.C. (OWNER/DOCTOR)
(507) 263-3925
Entity
Organization

Contact information

Practice address
6505 CEDAR HILLS DR, CANNON FALLS, MN 55009-4253
(507) 263-3925
(507) 263-5065
Mailing address
6505 CEDAR HILLS DR, CANNON FALLS, MN 55009-4253
(507) 263-3925
(507) 263-5065

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
4074
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01N79CA
BLUE CROSS/BLUE SHIELD
MN
Enumeration date
10/25/2006
Last updated
08/22/2020
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