Provider Demographics
NPI:1992992788
Name:HEIGHTS CHIROPRACTIC CLINIC PA
Entity type:Organization
Organization Name:HEIGHTS CHIROPRACTIC CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:DRIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-788-0515
Mailing Address - Street 1:4111 CENTRAL AVE NE STE 105
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-2957
Mailing Address - Country:US
Mailing Address - Phone:763-788-0515
Mailing Address - Fax:763-788-0418
Practice Address - Street 1:4111 CENTRAL AVE NE STE 105
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421
Practice Address - Country:US
Practice Address - Phone:763-788-0515
Practice Address - Fax:763-788-0418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNDB1110OtherPALMETTO GBA
MN03897HEOtherBLUE CROSS
MN286913600OtherMN MEDICAL ASSISTANCE