Provider Demographics
NPI:1194891697
Name:HILL, CHAD MENTER (DC)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:MENTER
Last Name:HILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13735 PENNOCK AVENUE
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-6103
Mailing Address - Country:US
Mailing Address - Phone:612-270-8938
Mailing Address - Fax:
Practice Address - Street 1:13735 PENNOCK AVENUE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-6103
Practice Address - Country:US
Practice Address - Phone:612-270-8938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3852111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1487052361OtherCMH CHIROPRACTIC
MN1124357983OtherINJURY CARE
MN1104952589OtherSHAKOPEE CHIROPRACTIC CENTER