Organization
ADVANCED BACK TECHNOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK LEWIS CLAUSSEN D.C. (CO-OWNER)
(952) 473-1663
Entity
Organization
Contact information
Practice address
1421 WAYZATA BLVD EAST, SUITE 70, WAYZATA, MN 55391
(952) 473-1663
(952) 473-9662
Mailing address
1421 WAYZATA BLVD EAST, SUITE 70, WAYZATA, MN 55391
(952) 473-1663
(952) 473-9662
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1911
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097K2AD
BLUE CROSS ID NUMBER
MN
Enumeration date
11/03/2006
Last updated
08/22/2020
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