# NIKOLE CARLSON, DC, LLC

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

## Provider details

- **NPI number:** 1699925479
- **Authorized official:** NIKOLE CARLSON (OWNER)
- **Authorized official phone:** (952) 925-4639

## Contact information

- **Practice address:** 6200 EXCELSIOR BLVD, \#204, ST LOUIS PARK, MN 55416-2730
- **Practice address phone:** (952) 925-4639
- **Practice address fax:** (952) 925-2404
- **Mailing address:** 6200 EXCELSIOR BLVD, \#204, ST LOUIS PARK, MN 55416-2730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 4595 | MN | Yes |

## Other

- **Enumeration date:** 09/29/2008
- **Last updated:** 09/29/2008