Provider Demographics
NPI:1992160477
Name:GEIDEL, JOSHUA RAY (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:RAY
Last Name:GEIDEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 VERMILLION ST STE A
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-3605
Mailing Address - Country:US
Mailing Address - Phone:651-409-2056
Mailing Address - Fax:651-382-1661
Practice Address - Street 1:1806 VERMILLION ST STE A
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-3605
Practice Address - Country:US
Practice Address - Phone:651-409-2056
Practice Address - Fax:651-382-1661
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN6166111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor