Individual
DR. DAVID WAYNE GOTTENBORG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12 5TH AVE. NE, PELICAN RAPIDS, MN 56572
(218) 863-2134
(218) 863-2135
Mailing address
PO BOX 385, PELICAN RAPIDS, MN 56572
(218) 863-2134
(218) 863-2135
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1952
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61177GO
BLUE CROSS BLUE SHIELD MN
MN
Enumeration date
08/20/2006
Last updated
11/14/2007
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