Organization
DONNER FAMILY CHIROPRACTIC PA
Active
Other names
Pauly Chiropractic Center PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN R DONNER DC (CEO)
(320) 235-8380
Entity
Organization
Contact information
Practice address
412 19TH AVE SW, WILLMAR, MN 56201-5297
(320) 235-8380
(320) 235-8381
Mailing address
412 19TH AVE SW, WILLMAR, MN 56201-5297
(320) 235-8380
(320) 235-8381
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1687
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332727200
—
MN
01
—
350046462
RR MEDICARE
MN
01
—
43232PA
BCBS
MN
01
—
755007
OPTUM HEALTH
MN
01
—
C03815
MEDICARE
MN
Enumeration date
11/01/2007
Last updated
09/12/2012
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