Eagle Trace Wellness Center, PA
NPI 1790932390ActiveOrganization· Chiropractor· Burnsville, MN
Chiropractor in Burnsville, Minnesota, registered in NPPES in August 2008. The authorized official on file is Elisa Marie Kensinger, D.C., Vice President, Secretary, Treasure. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1790932390 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 26, 2008 |
| Last updated in NPPES | Aug 26, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor Primary | 111N00000X | 5077 | MN |
| Chiropractor | 111N00000X | 5104 | MN |
| Acupuncturist | 171100000X | 832 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MN) |
|---|
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