Organization
MADISON CHIROPRACTIC CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLINTON A BONN DC (OWNER)
(320) 598-3089
Entity
Organization
Contact information
Practice address
508 W 4TH ST, MADISON, MN 56256-1426
(320) 598-3089
(320) 598-3211
Mailing address
508 W 4TH ST, MADISON, MN 56256
(218) 312-3002
(218) 312-3003
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
3882
MN
261QP3300X
Pain Clinic/Center
3882
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3BW40MA
BLUE CROSS BLUE SHIELD
MN
05
—
721157100
—
MN
Enumeration date
10/01/2009
Last updated
01/13/2010
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