Provider Demographics
NPI:1306532429
Name:NEVSIMAL CHIROPRACTIC LLC
Entity type:Organization
Organization Name:NEVSIMAL CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:NEVSIMAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-251-0704
Mailing Address - Street 1:4105 135TH ST
Mailing Address - Street 2:
Mailing Address - City:MAZEPPA
Mailing Address - State:MN
Mailing Address - Zip Code:55956-4164
Mailing Address - Country:US
Mailing Address - Phone:507-251-0704
Mailing Address - Fax:
Practice Address - Street 1:2150 2ND ST SW UNIT 140
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-4189
Practice Address - Country:US
Practice Address - Phone:507-251-0704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty