1194053884 NPI number — SAJ FAMILY CHIROPRACTIC P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194053884 NPI number — SAJ FAMILY CHIROPRACTIC P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAJ FAMILY CHIROPRACTIC P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194053884
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1610 HWY 52 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55901-1664
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-281-9566
Provider Business Mailing Address Fax Number:
507-281-9570

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1610 14TH ST NW
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55901-0229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-281-9566
Provider Business Practice Location Address Fax Number:
507-281-9570
Provider Enumeration Date:
11/18/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SAJ
Authorized Official First Name:
NATHAN
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR/OWNER
Authorized Official Telephone Number:
507-281-9566

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  3152 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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