Organization
GUNNERSON CHIROPRACTIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANE GUNNERSON (OWNER)
(218) 326-4022
Entity
Organization
Contact information
Practice address
1325 NW 4TH ST STE 200, GRAND RAPIDS, MN 55744-2209
(218) 326-4022
Mailing address
1325 NW 4TH ST STE 200, GRAND RAPIDS, MN 55744-2209
(218) 326-4022
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3335
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281827200
—
MN
01
—
350052380
RR MEDICARE
MN
01
—
4C806GU
BCBS
MN
Enumeration date
09/28/2006
Last updated
11/29/2011
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