Health Source Shorewood

NPI #1013140599 in Excelsior, Minnesota

Provider Information

NPI Number
1013140599
Entity Type
Organization
Organization Name
Health Source Shorewood
Primary Specialty
Chiropractor
Enumeration Date
Aug 31, 2009
Last Updated
Aug 31, 2009

Practice Location

Address
6140 LAKE LINDEN DR
Address 2
SUITE 100
ZIP Code
55331-2954
Phone
(952) 474-0886

Authorized Official

Name
DR. HOWARD FIDLER, DC
Title
PRESIDENT
Phone
(952) 474-0886

Specialties & Taxonomy Codes

Specialty
Chiropractor

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