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Organization
TREE OF LIFE CHIROPRACTIC CLINIC P.A.
Active
Organization
TREE OF LIFE CHIROPRACTIC CLINIC P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEDIDIAH KRAUSS D.C. (PRESIDENT/CEO)
(952) 345-8244
Entity
Organization
Contact information
Practice address
1001 TWELVE OAKS CENTER DRIVE, SUITE 1015, WAYZATA, MN 55391
(952) 345-8244
(763) 546-8793
Mailing address
1001 TWELVE OAKS CENTER DRIVE, SUITE 1015, WAYZATA, MN 55391
(952) 345-8244
(763) 546-8793
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8603611
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122231
HEALTH PARTNERS PROVIDER
—
01
—
230439
ACN PROVIDER
—
01
—
4402834
MEDICA PROVIDER
—
05
—
554327400
—
MN
01
—
979T7TR
BCBS GROUP PROVIDER
—
Enumeration date
02/13/2007
Last updated
09/15/2021
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