Jacob Jared Sundberg D.C.

NPI 1619096245 - Chiropractor - 111N00000X

NPI Details
NPI 1619096245
Gender Male
Enumeration Date 03/28/2007
Last Updated 08/01/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
15800 95TH AVE N
MAPLE GROVE MN, 55369-4400, US
Phone (952) 993-2259
Fax (952) 993-0980
Business Location
15800 95TH AVE N
MAPLE GROVE MN, 55369-4400, US
Phone (952) 993-2259
Fax (952) 993-0980
Toxanomy
Taxonomy Code 111N00000X
License State Minnesota
License Number 4924
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According to our database, Dr. Jacob Jared Sundberg D.C. NPI is 1619096245, taxonomy code is 111N00000X and license number is 4924, license state is located at Minnesota. Jacob Jared Sundberg D.C. physically located at 15800 95th Ave N, Maple Grove MN, 55369-4400. NPI Number Jacob Jared Sundberg D.C. has the Individual type.

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1619096245 NPI number is provided on an as is basis without warranty of any kind. 1619096245 is maintained by the National Plan & Provider Enumeration System. The contents of Jacob Jared Sundberg D.C. are for informational purposes only.