Provider Demographics
NPI:1538353669
Name:EXPLORE CHIROPRACTIC
Entity type:Organization
Organization Name:EXPLORE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BREMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-333-8811
Mailing Address - Street 1:223 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3111
Mailing Address - Country:US
Mailing Address - Phone:218-333-8811
Mailing Address - Fax:218-333-8813
Practice Address - Street 1:223 3RD ST NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3111
Practice Address - Country:US
Practice Address - Phone:218-333-8811
Practice Address - Fax:218-333-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty