| Dominique Giesen, DC | |
|
1660 Highway 100 S Ste 146, St Louis Park, MN 55416-1562 | |
| (952) 500-8477 | |
| Not Available |
| Full Name | Dominique Giesen |
|---|---|
| Gender | Female |
| Speciality | Chiropractor |
| Location | 1660 Highway 100 S Ste 146, St Louis Park, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538757604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 6796 (Minnesota) | Primary |
| Provider Name | Nova Chiropractic And Wellness |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1871212951 PECOS PAC ID: 6507231362 Enrollment ID: O20230407001746 |
| Mailing Address | Practice Location Address |
|---|---|
| Dominique Giesen, DC 15 E Franklin Ave Apt 320, Minneapolis, MN 55404-4481 Ph: (701) 471-6774 | Dominique Giesen, DC 1660 Highway 100 S Ste 146, St Louis Park, MN 55416-1562 Ph: (952) 500-8477 |
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