CENTRAL LAKES CHIROPRACTIC CLINIC PC (NPI# 1902861339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902861339 |
| Entity Type | Organization |
| Organization Name | CENTRAL LAKES CHIROPRACTIC CLINIC PC |
| Practice Address |
510 22nd Ave E Suite 701 Alexandria MN 56308-4653 |
| Practice Telephone | 3207639711 |
| Practice Fax Number | 3207639707 |
| Mailing Telephone | 3207639711 |
| Mailing Fax Number | 3207639707 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2014-02-21 |
| Authorized Official Name | DR. BARBARA L. DOLEZAL (PRESIDENT) |
| Authorized Official Telephone | 3207639711 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2218 | MN | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 757827000 | 05 |
| Street Address |
510 22ND AVE E SUITE 701 |
| City | ALEXANDRIA |
| State | MN |
| Zip Code | 56308-4653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053376459 | Barbara L. Dolezal | Chiropractor | 510 22nd Ave E, Suite 701, Alexandria, MN 56308-4653 | 2006-04-19 |
| 1407212210 | Zachary Maas | Chiropractor | 510 22nd Ave E, Ste. 701, Alexandria, MN 56308-4653 | 2016-01-08 |
| 1376966721 | Alexandria Chiropractic LLC | Chiropractor | 510 22nd Ave E, Suite 701, Alexandria, MN 56308-4653 | 2014-01-21 |
| 1598041956 | Benjamin Sear Whitten | Chiropractor | 510 22nd Ave E, Suite 701, Alexandria, MN 56308-4653 | 2011-10-31 |
| 1083899041 | Advance Orthotics & Prosthetics | Prosthetic/Orthotic Supplier | 510 22nd Ave E, Ste 801, Alexandria, MN 56308-4653 | 2008-01-08 |
| 1720274129 | David Michael Ellis | Orthotist | 510 22nd Ave E, Suite# 801 Advance Orthotics & Prosthetics, Alexandria, MN 56308-4653 | 2007-09-19 |
| 1427102722 | Kimberly Ann Rauk | Dentist | 510 22nd Ave E, Suite 601, Alexandria, MN 56308-4653 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104836 | Center for Pain Management Ambulatory Surgery, Ltd | Pain Medicine | 804 23rd Street South, Sartell, MN 56308 | 2020-08-13 |
| 1548815590 | Ritajo Ellenberger | Licensed Practical Nurse | 220 Oak Street North, Alexandria, MN 56308 | 2019-08-06 |
| 1346808714 | Vance Thompson Vision Surgery Center Alexandria, Prof LLC | Clinic/Center | 2600 Jefferson St, Alexandria, MN 56308 | 2019-05-31 |
| 1811452048 | Little Falls Eye Care Center Pa | Optometrist | 2306 S. Broadway Str. Suite 12, Alexandria, MN 56308 | 2019-02-01 |
| 1184167199 | Jennifer Lynn Craig | Technician | 2307 East Golf Course Rd, Alexandria, MN 56308 | 2016-11-22 |
| 1548712219 | Shelby Elisha Johnsrud | Chiropractor | 303 West 22nd Ave, Ste 100, Alexandria, MN 56308 | 2016-10-28 |
| 1811347867 | Dustin Matthew Ditch | Dentist | 510 22nd Ave E Ste 702, Alexandria, MN 56308 | 2016-06-20 |
| 1639538051 | West Central Chiropractic & Wellness, LLC | Chiropractor | 123 3rd Ave. E, Suite 100, Alexandria, MN 56308 | 2016-02-12 |
| 1659736221 | Amanda Jean Dahlseng | Registered Nurse | 809 Elm Street, Suite 1200, Alexandria, MN 56308 | 2015-12-23 |
| 1518358886 | Benjamin G Wenzel | Marriage & Family Therapist | 512 30th Ave S, Ste 100, Alexandria, MN 56308 | 2015-02-09 |
| Find all providers in zip 56308 | ||||
| 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 |
|---|---|---|---|---|
| 1255955928 | Ricardo Alejandro Rodriguez-vazquez | Chiropractor | 1727 King St Ste 322, Alexandria, VA 22314-2700 | 2020-05-29 |
| 1932733839 | Alexandria Chiropractic Clinic & Rehab, LLC | Chiropractor | 101 S Whiting St Ste 213, Alexandria, VA 22304-3416 | 2020-02-28 |
| 1508405861 | Stuart Donald Rubner | Chiropractor | 1804 Broadway St Ste 125, Alexandria, MN 56308-2686 | 2020-01-03 |
| 1104384940 | Ramon A Soto | Chiropractor | 5990 Richmond Hwy Apt 1019, Alexandria, VA 22303-2752 | 2019-03-11 |
| 1104398171 | Derek Goracke | Chiropractor | 510 22nd Ave E Ste 701, Alexandria, MN 56308-4817 | 2019-01-01 |
| 1831671155 | Melissa Ownby | Chiropractor | 115 S Saint Asaph St Ste D, Alexandria, VA 22314-3177 | 2018-09-04 |
| 1962990531 | Chancellor Eugene Foulks | Chiropractor | 6454 Old Beulah St, Alexandria, VA 22315-3721 | 2018-04-28 |
| 1528560430 | Jennifer Anne Briggs | Chiropractor | 1451 Belle Haven Rd Ste 330, Alexandria, VA 22307-1201 | 2018-03-06 |
| 1598203309 | Brian A Peters Jr. | Chiropractor | 1133 Macarthur Dr Ste B, Alexandria, LA 71303-3123 | 2017-02-01 |
| 1437694718 | Landon Edward Olson | Chiropractor | 507 N Nokomis St Ste B, Alexandria, MN 56308-2353 | 2016-12-22 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 56308 |
Please comment or provide details below to improve the information on CENTRAL LAKES CHIROPRACTIC CLINIC PC.
| 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.