Shoreview Spine and Sport Family Chiropractic, LLC

NPI #1841536323 in Shoreview, Minnesota

Provider Information

NPI Number: 1841536323
Entity Type: Organization
Organization Name: Shoreview Spine and Sport Family Chiropractic, LLC
Primary Specialty: Chiropractor
Enumeration Date: Jan 2, 2013
Last Updated: Jan 26, 2013

Practice Location

Address: 3434 LEXINGTON AVE N
Address 2: SUITE 900
City: Shoreview
State: Minnesota
ZIP Code: 55126-8069
Phone: (651) 447-2468

Authorized Official

Name: DR. CHAD LEROY HENDRICKSON, DC
Title: PRESIDENT/TREASURER/SECRETARY
Phone: (218) 205-0387

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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