Organization
HEALTH SOURCE SHOREWOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD FIDLER DC (PRESIDENT)
(952) 474-0886
Entity
Organization
Contact information
Practice address
6140 LAKE LINDEN DR, SUITE 100, EXCELSIOR, MN 55331-2954
(952) 474-0886
Mailing address
6140 LAKE LINDEN DR, SUITE 100, EXCELSIOR, MN 55331-2954
(952) 474-0886
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4856
MN
Other
Enumeration date
08/31/2009
Last updated
08/31/2009
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