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Organization
SHOREVIEW SPINE AND SPORT FAMILY CHIROPRACTIC, LLC
Active
Organization
SHOREVIEW SPINE AND SPORT FAMILY CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD LEROY HENDRICKSON DC (PRESIDENT/TREASURER/SECRETARY)
(218) 205-0387
Entity
Organization
Contact information
Practice address
3434 LEXINGTON AVE N, SUITE 900, SHOREVIEW, MN 55126-8069
(651) 447-2468
Mailing address
3434 LEXINGTON AVE N, SUITE 900, SHOREVIEW, MN 55126-8069
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5736
MN
Other
Enumeration date
01/02/2013
Last updated
01/26/2013
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