Wellnessone Of Crosslake
Chiropractor in Crosslake, MN. Organization (NPI-2).
NPI number1396795092
StatusActive
Last updated in NPPESDec 7, 2007
Details
- NPI
- 1396795092
- Entity type
- Organization (NPI-2)
- Legal business name
- Wellnessone Of Crosslake
- Organization subpart
- No
- Enumeration date
- May 11, 2006
- Last updated
- Dec 7, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | – | – | Yes |
Practice location
35272 County Road 3Crosslake, MN 56442-2804
Phone 218-692-3700 · Fax 218-692-3700
Mailing address
35272 County Road 3Crosslake, MN 56442-2804
Phone 218-692-3700 · Fax 218-692-3700
Authorized official
Derrek N Johnson
Owner/President
2186923700
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