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Organization
TRADITIONALLY HEALTHY
Active
Organization
TRADITIONALLY HEALTHY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARRIE CLARK D.C. (OWNER)
(612) 382-7408
Entity
Organization
Contact information
Practice address
1211 JACKSON ST NE, SUITE 121, MINNEAPOLIS, MN 55413
(612) 382-7408
Mailing address
9744 WOODRIDGE DR, EDEN PRAIRIE, MN 55347-4249
(612) 382-7497
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3928
MN
Other
Enumeration date
03/26/2014
Last updated
03/26/2014
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