Provider Demographics
NPI:1255742870
Name:PEARSON CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:PEARSON CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEVANNI
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:PARTRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-740-8777
Mailing Address - Street 1:1310 BURDICK EXPY E
Mailing Address - Street 2:SUITE A
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-4912
Mailing Address - Country:US
Mailing Address - Phone:701-852-5230
Mailing Address - Fax:
Practice Address - Street 1:1310 BURDICK EXPY E
Practice Address - Street 2:SUITE A
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4912
Practice Address - Country:US
Practice Address - Phone:701-852-5230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND969111N00000X
ND970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty