Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1218 | MN |
NPI | 1083708705 |
---|---|
Provider Name | Dr. Jeffrey W Falk |
First Address | Owatonna, MN 55060-6245 |
Second Address | Owatonna, MN 55060-3900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T65498 | (02) | MN |