Bothof, Michael John

Bothof, Michael John is an individual health care provider with primary practice located at 16154 Main Ave Se Ste 134A , Prior Lake MN 55372-4815. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Bothof, Michael John can be contacted via phone (952) 447-3000.

Contact Information

Primary practice address
16154 Main Ave Se Ste 134A Prior Lake MN 55372-4815
Phone: (952) 447-3000
Fax: (952) 447-3561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 3631 Minnesota

Profile Details

NPI number 1477622132
LBN Legal business name Bothof, Michael John
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2006
Last updated Jun 24th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477622132 NPPES
Minnesota Other 44-02426 MEDICA PROVIDER #
Minnesota Other 870G2BO MEDICA PROVIDER #
Minnesota Other HP58905 MEDICA PROVIDER #
Minnesota MEDICAID 642613100 MEDICA PROVIDER #
Minnesota Other 44-02425 MEDICA PROVIDER #
Minnesota Other 640618 MEDICA PROVIDER #

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