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Organization
ALLIED CHIROPRACTIC CENTER OF EAGAN PA.
Active
Organization
ALLIED CHIROPRACTIC CENTER OF EAGAN PA.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK CHARLES GUSTAFSON D.C. (CEO,CHIROPRACTOR)
(612) 709-3104
Entity
Organization
Contact information
Practice address
3916 W 113TH ST, BLOOMINGTON, MN 55437-3503
(612) 709-3104
(952) 884-0852
Mailing address
3916 W 113TH ST, BLOOMINGTON, MN 55437-3503
(612) 709-3104
(952) 884-0852
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2493
MN
Other
Enumeration date
11/16/2006
Last updated
08/22/2020
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