Provider Demographics
NPI:1699075366
Name:A. J. LINN CHIROPRACTIC LLC
Entity type:Organization
Organization Name:A. J. LINN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JON
Authorized Official - Last Name:LINN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-856-8500
Mailing Address - Street 1:PO BOX 377
Mailing Address - Street 2:
Mailing Address - City:ZIMMERMAN
Mailing Address - State:MN
Mailing Address - Zip Code:55398-0377
Mailing Address - Country:US
Mailing Address - Phone:763-856-8500
Mailing Address - Fax:763-856-8502
Practice Address - Street 1:26144 3RD ST E
Practice Address - Street 2:
Practice Address - City:ZIMMERMAN
Practice Address - State:MN
Practice Address - Zip Code:55398-9305
Practice Address - Country:US
Practice Address - Phone:763-856-8500
Practice Address - Fax:763-856-8502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4397111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN250033000Medicaid
MN1DD41AJOtherBCBSMN
MNP00087309OtherRAIL ROAD MEDICARE
MNU95108Medicare UPIN
MN250033000Medicaid