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Organization

PRINCETON BACK AND NECK CLINIC PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN CRAIG VANHOOSER D.C. (PRESIDENT)
(763) 631-2225
Entity
Organization

Contact information

Practice address
209 RUM RIVER DR N, SUITE 2, PRINCETON, MN 55371-1609
(763) 631-2225
Mailing address
209 RUM RIVER DR N, SUITE 2, PRINCETON, MN 55371-1609
(763) 631-2225

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1677
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
350004181
MEDICARE PTAN
MN
Enumeration date
05/09/2012
Last updated
05/09/2012
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