612 Chiropractic & Wellness
NPI #1518414382 in Mendota Heights, Minnesota
Provider Information
- NPI Number
- 1518414382
- Entity Type
- Organization
- Organization Name
- 612 Chiropractic & Wellness
- Primary Specialty
- Chiropractor
- Enumeration Date
- Sep 8, 2016
- Last Updated
- Sep 8, 2016
Practice Location
- Address
- 750 MAIN ST
- Address 2
- SUITE 100
- City
- Mendota Heights
- State
- Minnesota
- ZIP Code
- 55118-3764
- Phone
- (612) 578-6001
Authorized Official
- Name
- KELLEY LUMBARD, DC
- Title
- OWNER
- Phone
- (612) 578-6001
Specialties & Taxonomy Codes
| Specialty |
|---|
| Chiropractor |
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