Provider Demographics
NPI:1306053673
Name:MOUNDS VIEW CHIROPRACTIC, PA
Entity type:Organization
Organization Name:MOUNDS VIEW CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-398-7770
Mailing Address - Street 1:5372 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1402
Mailing Address - Country:US
Mailing Address - Phone:763-398-7770
Mailing Address - Fax:763-398-7771
Practice Address - Street 1:5372 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55112-1402
Practice Address - Country:US
Practice Address - Phone:763-398-7770
Practice Address - Fax:763-398-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty