Healthsource Of White Bear Lake, Pllc

NPI 1073767372 - Chiropractor - 111N00000X

NPI Details
NPI 1073767372
Enumeration Date 11/13/2008
Last Updated 02/12/2010
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name MICHAEL LEO MICHAEL
Position CHIROPRACTOR
Phone (651) 762-5433
Fax (651) 762-7504
Practice Location
4801 HIGHWAY 61 N
105
WHITE BEAR LAKE MN, 55110-2737, US
Phone (651) 762-5433
Fax (651) 762-7504
Business Location
4801 HIGHWAY 61 N
105
WHITE BEAR LAKE MN, 55110-2737, US
Phone (651) 762-5433
Fax (651) 762-7504
Toxanomy
Taxonomy Code 111N00000X
License State Minnesota
License Number 5114
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According to our database, Healthsource Of White Bear Lake, Pllc NPI is 1073767372, taxonomy code is 111N00000X and license number is 5114, license state is located at Minnesota. Healthsource Of White Bear Lake, Pllc physically located at 4801 Highway 61 N, White Bear Lake MN, 55110-2737. NPI Number 1033115704 has the healthcare provider type.

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1073767372 NPI number is provided on an as is basis without warranty of any kind. 1073767372 is maintained by the National Plan & Provider Enumeration System. The contents of Healthsource Of White Bear Lake, Pllc are for informational purposes only.