Paulick, Ty Evan

Paulick, Ty Evan is an individual health care provider with primary practice located at 4801 Highway 61 N Suite 105, White Bear Lake MN 55110-2737. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Paulick, Ty Evan can be contacted via phone (651) 762-5433.

Contact Information

Primary practice address
4801 Highway 61 N Suite 105 White Bear Lake MN 55110-2737
Phone: (651) 762-5433
Fax: (651) 762-7504
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 5105 Minnesota

Profile Details

NPI number 1902071285
LBN Legal business name Paulick, Ty Evan
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2008
Last updated Feb 10th, 2010 - about 16 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 1902071285 NPPES
Minnesota MEDICAID 350004088

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