Inner Light Chiropractic, P.A.

Chiropractor · Brooklyn Park, MN

Organization Active NPI

NPI number 1396715686

Practice location

4630 97TH Ave N
Brooklyn Park, MN 55443
Phone
(763) 486-3945

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NPI record

NPI
1396715686
Entity type
Organization (Type 2)
Enumeration date
January 26, 2006
Last updated
August 22, 2020
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Chiropractor Primary 111N00000X 4717 MN

Authorized official

Name
Dr. Russell S. Derhak, D.C.
Title
President
Phone
(612) 749-4600

About Inner Light Chiropractic, P.A.

Inner Light Chiropractic, P.A. is a healthcare organization registered in the NPI registry with the primary taxonomy Chiropractor (code 111N00000X). The practice location is 4630 97TH Ave N, Brooklyn Park, MN 55443. The NPI number 1396715686 was assigned on January 26, 2006 and the record was last updated on August 22, 2020.

Inner Light Chiropractic, P.A. lists a license in the registry: #4717 (MN) for Chiropractor. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. Russell S. Derhak, D.C., President.

Frequently asked questions

What is the NPI number of Inner Light Chiropractic, P.A.?

The NPI number is 1396715686.

What is the phone number of Inner Light Chiropractic, P.A.?

The phone number listed for the practice location is (763) 486-3945.

Where is Inner Light Chiropractic, P.A. located?

4630 97TH Ave N, Brooklyn Park, MN 55443.

What is the taxonomy code for Inner Light Chiropractic, P.A.?

The primary taxonomy code is 111N00000X – Chiropractor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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