Izabella Raeh Dieken, DC | |
2822 W 43rd St, Minneapolis, MN 55410-1696 | |
(612) 767-4680 | |
Not Available |
Full Name | Izabella Raeh Dieken |
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Gender | Female |
Speciality | Chiropractor |
Location | 2822 W 43rd St, Minneapolis, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083477855 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 7208 (Minnesota) | Primary |
Provider Name | Sunu Linden Hills Pllc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1699028183 PECOS PAC ID: 1153568068 Enrollment ID: O20130514000281 |
Mailing Address | Practice Location Address |
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Izabella Raeh Dieken, DC 3513 Welcome Ave N, Minneapolis, MN 55422-2635 Ph: (507) 828-6434 | Izabella Raeh Dieken, DC 2822 W 43rd St, Minneapolis, MN 55410-1696 Ph: (612) 767-4680 |
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