Organization
SPINAL REHAB CLINICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL T CARLSON DC (CEO)
(320) 252-2225
Entity
Organization
Contact information
Practice address
225 N BENTON DR STE 105, SAUK RAPIDS, MN 56379-1574
(320) 252-2225
(320) 252-2159
Mailing address
225 N BENTON DR STE 105, SAUK RAPIDS, MN 56379-1574
(320) 252-2225
(320) 252-2159
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55040MC
BLUE CROSS BLUE SHIELD
MN
05
—
799325100
—
MN
01
—
CS4516
RAILROAD MEDICARE
MN
Enumeration date
03/01/2007
Last updated
06/16/2018
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