Provider Demographics
NPI:1992988265
Name:HJORT FAMILY CHIROPRACTIC, P.A.
Entity type:Organization
Organization Name:HJORT FAMILY CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HJORT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-266-8674
Mailing Address - Street 1:9125 QUADAY AVE NE STE 102
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-6662
Mailing Address - Country:US
Mailing Address - Phone:320-266-8674
Mailing Address - Fax:
Practice Address - Street 1:9125 QUADAY AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-6662
Practice Address - Country:US
Practice Address - Phone:320-266-8674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4434111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U96749Medicare UPIN
MN350003346Medicare PIN