NORTHERN LAKES CHIROPRACTIC LLC (NPI# 1396371571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396371571 |
| Entity Type | Organization |
| Organization Name | NORTHERN LAKES CHIROPRACTIC LLC |
| Practice Address |
2340 Mountain Shadow Dr Duluth MN 55811-3809 |
| Practice Telephone | 2182084627 |
| Mailing Telephone | 2182084627 |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2020-03-19 |
| Authorized Official Name | DR. BRYCE BENSON (OWNER) |
| Authorized Official Telephone | 2182084627 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Street Address |
2340 MOUNTAIN SHADOW DR |
| City | DULUTH |
| State | MN |
| Zip Code | 55811-3809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124654306 | Bryce Benson | Chiropractor | 2340 Mountain Shadow Dr, Duluth, MN 55811-3809 | 2020-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417515339 | Kyle Olson-merrick | Dentist | 320 W Myrtle St, Ste 100, Duluth, MN 55811 | 2019-06-05 |
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1528589843 | Breanna Joy Greenly | Counselor | 4720 Burning Tree Road, Birch Tree Center, Duluth, MN 55811 | 2017-06-28 |
| 1396102398 | Debbie Christian | Registered Nurse | 4815 Burning Tree Rd Suite 100, Duluth, MN 55811 | 2016-01-21 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1740666908 | Angela Fedo | Physical Therapy Assistant | 2101 Trinity Rd, Duluth, MN 55811 | 2015-08-10 |
| 1649657479 | Kayla Stephenson | Specialist/Technologist | 5024 Morris Thomas Road, Hermantown, MN 55811 | 2015-04-30 |
| 1073918843 | Northern Lives Inc. | Assisted Living Facility | 4014 Trinity Road, Duluth, MN 55811 | 2014-10-23 |
| 1114326238 | Donald Hermanson | Specialist/Technologist | 801 Boulder Drive, Apt. 202, Duluth, MN 55811 | 2014-08-14 |
| 1679990857 | Jodie Little | Pharmacist | 801 W. Central Entrance, Shopko Pharmacy 2114, Duluth, MN 55811 | 2014-03-25 |
| Find all providers in zip 55811 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164034591 | Chantelle Frazier | Chiropractor | 2131 Pleasant Hill Rd Ste 122, Duluth, GA 30096-4657 | 2020-08-18 |
| 1578113973 | Chester Creek Chiropractic | Chiropractor | 1324 E 4th St Ste A, Duluth, MN 55805-2335 | 2019-09-17 |
| 1467007997 | Pleasant Hill Chiropractic | Chiropractor | 4390 Pleasant Hill Rd Ste G, Duluth, GA 30096-8054 | 2019-08-01 |
| 1851951024 | Marian Denisse Ortiz Rodriguez | Chiropractor | 3775 Venture Dr Bldg F, Duluth, GA 30096-5102 | 2019-06-19 |
| 1396234613 | Sangsoo Lee | Chiropractor | 2148 Duluth Highway 120 Ste 110, Duluth, GA 30097-4504 | 2018-05-02 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1942708235 | Kyle Severson | Chiropractor | 224 E Central Entrance Ste C, Duluth, MN 55811-5518 | 2018-02-01 |
| 1669987228 | Frances Hearn | Chiropractor | 2719 Irene Cir, Duluth, GA 30096-4149 | 2017-12-05 |
| 1467966911 | Corey Steven Milbrandt | Chiropractor | 925 E Superior St Ste 112, Duluth, MN 55802-2253 | 2017-11-20 |
| 1700312535 | Angella Perotti | Chiropractor | 3750 Venture Dr Ste D9, Duluth, GA 30096 | 2017-05-11 |
| Find all providers in DULUTH | ||||
Please comment or provide details below to improve the information on NORTHERN LAKES CHIROPRACTIC LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.