NPI 1366631244

Eagle Creek Wellness Center LLC

Organisation Chiropractor Prior Lake, MN

Practice location

Address: 14180 Commerce Ave NE, Prior Lake, MN 55372-1483
Phone: (952) 447-3395
Fax: (952) 447-3396

Authorised official

Name: Nicholas David Anderson
Title: Owner
Phone: (952) 447-9935

Registered specialties

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X Licence DC3496 (MN)

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Registry record

NPI: 1366631244
Entity type: Organization
NPI issued: 17 Oct 2007
Record last updated: 2 Mar 2020

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.