Organization
VALLEY SPINE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALISA T MITSKOG D.C. (PRESIDENT)
(701) 642-6480
Entity
Organization
Contact information
Practice address
319 11TH ST N, WAHPETON, ND 58075-4111
(701) 642-6480
(701) 642-6011
Mailing address
PO BOX 561, WAHPETON, ND 58074-0561
(701) 642-6480
(701) 642-6011
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
289
ND
111N00000X
Chiropractor
750
ND
111NS0005X
Sports Physician Chiropractor
Primary
500
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13184
—
ND
05
—
13349
—
ND
05
—
16659600
—
MN
05
—
17175
—
ND
01
—
24675
BCBS
ND
01
—
25401
BCBS DR. ROBB DOHMAN
ND
01
—
25402
BCBS DR. ALISA MITSKOG
ND
01
—
296001
BCBS WAHPETON
ND
05
—
500688100
—
MN
01
—
634001
BCBS LIDGERWOOD
ND
01
—
71653MI
BCBS
MN
01
—
91002MI
BCBS
MN
05
—
922509900
—
MN
Enumeration date
04/10/2007
Last updated
04/22/2013
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