Provider Demographics
NPI:1285939710
Name:R.J. SASS, INC.
Entity type:Organization
Organization Name:R.J. SASS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SASS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-429-0640
Mailing Address - Street 1:4436 HIGHWAY 61 N
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-3720
Mailing Address - Country:US
Mailing Address - Phone:651-429-0640
Mailing Address - Fax:651-426-1329
Practice Address - Street 1:4436 HIGHWAY 61 N
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-3720
Practice Address - Country:US
Practice Address - Phone:651-429-0640
Practice Address - Fax:651-426-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350001579Medicare PIN