Innovative Chiropractic Center

NPI #1790182335 in Red Wing, Minnesota

Provider Information

NPI Number: 1790182335
Entity Type: Organization
Organization Name: Innovative Chiropractic Center
Primary Specialty: Chiropractor
Enumeration Date: Nov 25, 2014
Last Updated: Nov 25, 2014

Practice Location

Address: 201 D EAST AVE.
City: Red Wing
State: Minnesota
ZIP Code: 55041
Phone: (651) 448-1481

Authorized Official

Name: DR. RYAN SHANE LYSTAD, D.C.
Title: CO-OWNER
Phone: (651) 448-1481

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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