Provider Demographics
NPI:1972264083
Name:CHIROSTRENGTH TWIN CITIES LLC
Entity type:Organization
Organization Name:CHIROSTRENGTH TWIN CITIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:LOXTERCAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS, CSCS
Authorized Official - Phone:320-309-3388
Mailing Address - Street 1:474 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-1402
Mailing Address - Country:US
Mailing Address - Phone:320-309-3388
Mailing Address - Fax:
Practice Address - Street 1:11311 DAYTON RIVER RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:MN
Practice Address - Zip Code:55327-7500
Practice Address - Country:US
Practice Address - Phone:612-314-0268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty