Organization
GREEN LAKE CHIROPRACTIC, PA
Active
Other names
Meridian Disc Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON D. HAEFNER D.C. (PRESIDENT)
(320) 214-0044
Entity
Organization
Contact information
Practice address
205 5TH ST SW, WILLMAR, MN 56201-3211
(320) 214-0044
(320) 214-0045
Mailing address
205 5TH ST SW, WILLMAR, MN 56201-3211
(320) 214-0044
(320) 214-0045
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
4176
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062M1GR
MN BCBS
MN
01
—
0868
HEALTH SERVICE MGMT.
MN
01
—
627686
ACN GROUP
MN
Enumeration date
02/05/2008
Last updated
06/02/2008
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