Gottenborg, David Wayne
Gottenborg, David Wayne is an sole proprietor health care provider with primary practice located at 12 5Th Ave. Ne , Pelican Rapids MN 56572. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Gottenborg, David Wayne can be contacted via phone (218) 863-2134.Contact Information
Primary practice address
12 5Th Ave. Ne
Pelican Rapids MN 56572
Phone: (218) 863-2134
Fax: (218) 863-2135
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 1952 | Minnesota |
Profile Details
| NPI number | 1053426171 |
|---|---|
| LBN Legal business name | Gottenborg, David Wayne |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 20th, 2006 |
| Last updated | Nov 14th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053426171 | NPPES |
| Minnesota | Other | 61177GO | BLUE CROSS BLUE SHIELD MN |
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