NPI 1225309248

Pure Life Chiropractic and Wellness Center, LTD

Organisation Point of Service Glencoe, MN

Practice location

Address: 920 10th St E, Glencoe, MN 55336-2301
Phone: (320) 864-6249
Fax: (320) 864-6243

Authorised official

Name: Nicholas Ryan Johnson
Title: President/Owner
Phone: (320) 864-6249

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 5603 (MN)

Other Point of Service providers in Minnesota →

Registry record

NPI: 1225309248
Entity type: Organization
NPI issued: 23 Jan 2012
Record last updated: 23 Jan 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.