Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2656 | MN |
NPI | 1003914409 |
---|---|
Provider Name | Dr. Paul A Hjort |
First Address | Saint Cloud, MN 56301-4031 |
Second Address | Saint Cloud, MN 56301-4031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 09/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9982221-00 | (05) | MN |
U55220 | (02) | MN |