# OTSEGO WEST CHIROPRACTIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518121656
- **Authorized official:** DR. DENNIS STULL DC (PRESIDENT)
- **Authorized official phone:** (763) 229-2552

## Contact information

- **Practice address:** 16201 90TH ST NE, SUITE 205, OTSEGO, MN 55330-7438
- **Practice address phone:** (763) 229-2552
- **Mailing address:** 16201 90TH ST NE, SUITE 205, OTSEGO, MN 55330-7438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 4775 | MN | Yes |

## Other

- **Enumeration date:** 07/17/2008
- **Last updated:** 07/17/2008