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PEQUOT LAKES CHIROPRACTIC PA
NPI 1417540774
Chiropractor in Pequot Lakes, MN

Active since February 18, 2021
31095 BERQUIST DR, PEQUOT LAKES, MN 56472(218) 568-7767(218) 568-4580 Get Directions Write a Review

NPPES record last updated: February 18, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pequot Lakes Chiropractic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEQUOT LAKES CHIROPRACTIC PA (NPI 1417540774) is a healthcare organization registered as a chiropractor in Pequot Lakes, Minnesota and active in the NPI registry since February 2021. The organization lists Joshua Alan Dietze, Owner, as its authorized official.

NPPES Registry Identity

NPI1417540774
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NamePEQUOT LAKES CHIROPRACTIC PA
Location Address31095 BERQUIST DRPequot Lakes, MN 56472-5647
Mailing AddressPo Box 281Pequot Lakes, MN 56472-0241 · (218) 568-7767 · Fax (218) 568-4580
Phone(218) 568-7767
Fax(218) 568-4580
Organization SubpartNo
Authorized OfficialJoshua Alan DietzeOwner · (218) 568-7677
Enumeration DateFebruary 18, 2021
NPPES CertifiedJanuary 28, 2021
✔ NPI 1417540774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
31095 BERQUIST DR, Pequot Lakes, MN 56472
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOSHUA ALAN DIETZE DC
Chiropractor
31095 BERQUIST DR
PEQUOT LAKES, MN 56472
Crow Wing County (218) 568-7767

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pequot Lakes Chiropractic PA's NPI number?

The NPI number for Pequot Lakes Chiropractic PA is 1417540774. It was assigned to this organization in the NPPES registry on February 18, 2021.

Where is Pequot Lakes Chiropractic PA located?

Pequot Lakes Chiropractic PA is located at 31095 Berquist Dr, Pequot Lakes, MN 56472. The listed phone number is (218) 568-7767.

What is Pequot Lakes Chiropractic PA's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Pequot Lakes Chiropractic PA was last updated on February 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.