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DR. WILLIAM GEORGE KULLBERG D.C.

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1972679777

Individual Registrant:
DR. WILLIAM GEORGE KULLBERG D.C.
Gender: M
Sole Proprietor

Location and contact information for practice:
606 EIGHTH AVE  HOWARD LAKE, MN 55349 US
Tel: 320-543-2345  Fax: --

Contact information for business:
606 8TH AVE P.O. BOX 548 HOWARD LAKE, MN 55349 US
Tel: 320-543-2345  Fax: --

Registration Information:
NPI: 1972679777
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
MN001587

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MINNESOTA CHIRO LIC #001587MN01
BCBS CONTRACT PROVIDER #08417KUMN01
INDIVIDUAL PROVIDER #68093KUMN01




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