Organization
CHIROPRACTIC SERVICS LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT L THATCHER D.C. (CLINIC DIRECTOR)
(651) 484-8448
Entity
Organization
Contact information
Practice address
1050 COUNTY ROAD E W, SHOREVIEW, MN 55126-8062
(651) 484-8448
Mailing address
1050 COUNTY ROAD E W, SHOREVIEW, MN 55126-8062
(651) 484-8448
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
62
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366581027
INDIVIDUAL NPI
—
01
—
1B21367CH
BLUE CROSS BLUE SHIELD
—
05
—
85825100
—
MN
Enumeration date
11/09/2007
Last updated
04/15/2008
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