Organization
BOOMAN CHIROPRACTIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DAVID BOOMAN D.C. (OWNER)
(507) 498-5445
Entity
Organization
Contact information
Practice address
102 1ST STREET SE, SPRING GROVE, MN 55974
(507) 498-5445
(507) 498-3577
Mailing address
102 1ST STREET SE, SPRING GROVE, MN 55974
(507) 498-5445
(507) 498-3577
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2367
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06952BO
BCBS PROVIDER NUMBER
MN
01
—
231665
CHIROCARE PROV NUMBER
MN
Enumeration date
10/05/2006
Last updated
08/22/2020
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