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Organization

MADISON CHIROPRACTIC CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CLINTON A BONN D.C. (OWNER)
(320) 598-3089
Entity
Organization

Contact information

Practice address
508 W 4TH ST, MADISON, MN 56256-1426
(320) 598-3089
(320) 598-3211
Mailing address
508 W 4TH ST, MADISON, MN 56256-1426
(320) 598-3089
(320) 598-3211

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3882
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
54B82MA
BLUE CROSS BLUE SHIELD
MN
05
721157100
MN
Enumeration date
10/26/2006
Last updated
11/18/2008
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