Organization
ELLENBECKER CHIROPRACTIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL DOUGLAS ELLENBECKER DC (PRESIDENT/OWNER)
(701) 838-1987
Entity
Organization
Contact information
Practice address
1050 31ST AVE SW, SUITE B, MINOT, ND 58701-2005
(701) 838-1987
(701) 838-3497
Mailing address
1050 31ST AVE SW, SUITE B, MINOT, ND 58701-2005
(701) 838-1987
(701) 838-3497
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
440
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05586001
BLUE SHIELD
ND
Enumeration date
12/06/2007
Last updated
12/06/2007
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