Organization
PARK CHIROPRACTIC CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CHARLES ANDERSON D.C. (PRESIDENT)
(320) 252-8383
Entity
Organization
Contact information
Practice address
4 13TH AVE N, WAITE PARK, MN 56387-1036
(320) 252-8383
(320) 252-9028
Mailing address
4 13TH AVE N, WAITE PARK, MN 56387-1036
(320) 252-8383
(320) 252-9028
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
364
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155216300
—
MN
01
—
6C337PA
BCBS
MN
Enumeration date
07/28/2006
Last updated
01/02/2013
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