Northwoods Spine Instsitute, Pa

NPI 1013100395 - Chiropractor - 111N00000X

NPI Details
NPI 1013100395
Enumeration Date 08/21/2007
Last Updated 08/21/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name GARY LEE GARY
Position PRESIDENT/DOCTOR
Phone (763) 533-7700
Fax (763) 533-6670
Practice Location
5524 W BROADWAY AVE
CRYSTAL MN, 55428-3508, US
Phone (763) 533-7700
Fax (763) 533-6670
Business Location
5524 W BROADWAY AVE
CRYSTAL MN, 55428-3508, US
Phone (763) 533-7700
Fax (763) 533-6670
Toxanomy
Taxonomy Code 111N00000X
License State Minnesota
License Number 4522
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According to our database, Northwoods Spine Instsitute, Pa NPI is 1013100395, taxonomy code is 111N00000X and license number is 4522, license state is located at Minnesota. Northwoods Spine Instsitute, Pa physically located at 5524 W Broadway Ave, Crystal MN, 55428-3508. NPI Number 1033115704 has the healthcare provider type.

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1013100395 NPI number is provided on an as is basis without warranty of any kind. 1013100395 is maintained by the National Plan & Provider Enumeration System. The contents of Northwoods Spine Instsitute, Pa are for informational purposes only.