OrganizationActive
Pequot Lakes Chiropractic PA
NPI 1417540774 · Chiropractor · Pequot Lakes, MN
Provider details
- NPI number
- 1417540774
- Entity type
- Organization
- Primary specialty
- ChiropractorChiropractic Providers
- Organization subpart
- No
- Authorized official
- Joshua Dietze, Owner(218) 568-7677
Specialties & taxonomies
Chiropractic Providers
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
31095 Berquist Dr
Pequot Lakes, MN 56472-5647
Phone: (218) 568-7767
Fax: (218) 568-4580
Street-level locationGet directions
Mailing address
Po Box 281
Pequot Lakes, MN 56472-0241
Registry dates
- Enumerated
- 2021-02-18
- Last updated
- 2021-02-18
- Certified
- 2021-01-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.