Organization
WANAMINGO CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT LEININGER (OWNER)
(507) 824-2336
Entity
Organization
Contact information
Practice address
200 MAIN ST, WANAMINGO, MN 55983-3848
(507) 824-2336
Mailing address
PO BOX 214, WANAMINGO, MN 55983-0214
(507) 824-2336
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4846
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
428319800
—
MN
Enumeration date
05/14/2009
Last updated
05/20/2009
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