Provider Demographics
NPI:1699920249
Name:VITALITY CHIROPRACTIC: A WELLNESS GUIDE CENTRE P.C.
Entity type:Organization
Organization Name:VITALITY CHIROPRACTIC: A WELLNESS GUIDE CENTRE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FROEHLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-746-5351
Mailing Address - Street 1:935 WAYZATA BLVD E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1849
Mailing Address - Country:US
Mailing Address - Phone:952-746-5351
Mailing Address - Fax:952-746-5097
Practice Address - Street 1:935 WAYZATA BLVD E
Practice Address - Street 2:SUITE 100
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-1849
Practice Address - Country:US
Practice Address - Phone:952-746-5351
Practice Address - Fax:952-746-5097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty