Organization
HENNING CHIROPRACTIC CLINIC, P.A.
Active
Other names
Henning Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DAVID MORTENSON DC (DOCTOR OF CHIROPRACTIC/OWNER)
(218) 548-2447
Entity
Organization
Contact information
Practice address
801 INMAN ST., HENNING, MN 56551
(218) 548-2447
(218) 548-2448
Mailing address
P.O. BOX 134, 801 INMAN ST.,, HENNING, MN 56551
(218) 548-2447
(218) 548-2448
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3941
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1334085-00
—
MN
01
—
36D46HE
BCBS
MN
Enumeration date
02/26/2010
Last updated
02/26/2010
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