Individual
DR. ROGER E PERREAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
263 W 4TH ST, RUSH CITY, MN 55069
(320) 358-3441
(320) 358-3624
Mailing address
263 W 4TH ST, PO BOX 86, RUSH CITY, MN 55069
(320) 358-3441
(320) 358-3624
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1666
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1D067PE
BCBSM
—
01
—
230668
ACN CHIRO CARE
—
05
—
511827100
—
MN
Enumeration date
06/19/2006
Last updated
04/28/2017
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