Provider Demographics
NPI:1548639586
Name:PERFECT TOUCH MASSAGE & CHIROPRACTIC, LTD
Entity type:Organization
Organization Name:PERFECT TOUCH MASSAGE & CHIROPRACTIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:KLERSY-MOHR
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CMT
Authorized Official - Phone:763-746-3344
Mailing Address - Street 1:377 JAY WAY
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-7953
Mailing Address - Country:US
Mailing Address - Phone:763-746-3344
Mailing Address - Fax:
Practice Address - Street 1:3101 OLD HIGHWAY 8
Practice Address - Street 2:SUITE 300
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1072
Practice Address - Country:US
Practice Address - Phone:763-746-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6117111N00000X, 261QP2300X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty