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Organization
ROBERT T. THIRY
Active
Organization
ROBERT T. THIRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT T THIRY D.C. (PRESIDENT)
(612) 695-4890
Entity
Organization
Contact information
Practice address
1608 W 155TH ST, BURNSVILLE, MN 55306-5308
(612) 695-4890
Mailing address
PO BOX 3047, BURNSVILLE, MN 55337-8047
(612) 695-4890
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1472
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780747428
NPI FOR INDIVIDUAL
MN
01
—
29064TH
BLUE CROSS BLUE SHIELD
MN
01
—
350610864
MEDICARE ID
MN
Enumeration date
12/20/2006
Last updated
12/09/2013
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