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Organization
WELLNESS & LONGEVITY CENTER
Active
Organization
WELLNESS & LONGEVITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA LEA SPORE DC (CLINIC DIRECTOR)
(651) 439-1013
Entity
Organization
Contact information
Practice address
1530 FRONTAGE RD W, VALLEY RIDGE MALL, STILLWATER, MN 55082-2102
(651) 439-1013
(651) 439-3465
Mailing address
1530 FRONTAGE RD W, VALLEY RIDGE MALL, STILLWATER, MN 55082-2102
(651) 439-1013
(651) 439-3465
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2810
MN
Other
Enumeration date
09/13/2006
Last updated
08/22/2020
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