Organization
DOWNTOWN CHIROPRACTIC LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEROY FRANK OTTO D.C. (PRESIDENT)
(651) 388-3212
Entity
Organization
Contact information
Practice address
212 FULTON ST, RED WING, MN 55066-2219
(651) 388-3212
(651) 385-0255
Mailing address
212 FULTON ST, RED WING, MN 55066-2219
(651) 388-3212
(651) 385-0255
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
188
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31144DO
BCBS GROUP NUMBER
MN
Enumeration date
11/17/2006
Last updated
10/10/2007
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