| |
200 E Travelers Trail, Suite 105, Burnsville, MN 55337 | |
(952) 707-0110 | |
(952) 707-0115 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center |
Location | 200 E Travelers Trail, Burnsville, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215120373 | NPI | - | NPPES |
255KOFL | Other | MN | BCBS |
254K9SO | Other | MN | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 4440 (Minnesota) | Secondary |
261Q00000X | Clinic/center | (Minnesota) | Primary |
Mailing Address | Practice Location Address |
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200 E Travelers Trail, Suite 105, Burnsville, MN 55337 Ph: (952) 707-0110 | 200 E Travelers Trail, Suite 105, Burnsville, MN 55337 Ph: (952) 707-0110 |