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Organization
COTTAGE GROVE CHIROPRACTIC CLINIC, PA
Active
Organization
COTTAGE GROVE CHIROPRACTIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN D DELCASTILLO DC (OWNER)
(651) 459-0066
Entity
Organization
Contact information
Practice address
7702 80TH ST S, COTTAGE GROVE, MN 55016-3194
(651) 459-0066
(651) 459-8005
Mailing address
7702 80TH ST S, COTTAGE GROVE, MN 55016-3194
(651) 459-0066
(651) 459-8005
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1398
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230556
ACN
—
01
—
4576
HEALTH PARTNERS
—
01
—
56037CO
BLUE CROSS BLUE SHIELD
MN
05
—
995227600
—
MN
Enumeration date
10/27/2009
Last updated
10/27/2009
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