Provider Demographics
NPI:1215177621
Name:ACC P.A.
Entity type:Organization
Organization Name:ACC P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:VOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-261-9967
Mailing Address - Street 1:607 W CHANDLER ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55307-2127
Mailing Address - Country:US
Mailing Address - Phone:507-964-2850
Mailing Address - Fax:507-964-2333
Practice Address - Street 1:607 W CHANDLER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MN
Practice Address - Zip Code:55307-2127
Practice Address - Country:US
Practice Address - Phone:507-964-2850
Practice Address - Fax:507-964-2333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5148111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty