Provider Demographics
NPI:1962690784
Name:ANDRASHKO CHIROPRACTIC PLUS PC
Entity type:Organization
Organization Name:ANDRASHKO CHIROPRACTIC PLUS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRASHKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-253-3880
Mailing Address - Street 1:8421 WAYZATA BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1380
Mailing Address - Country:US
Mailing Address - Phone:952-253-3880
Mailing Address - Fax:952-253-3882
Practice Address - Street 1:8421 WAYZATA BLVD STE 220
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426
Practice Address - Country:US
Practice Address - Phone:952-253-3880
Practice Address - Fax:952-253-3882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3457111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5C733ANOtherBLUE CROSS BLUE SHIELD
U68942Medicare UPIN