Individual
LUCY ANN GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
470 HIGHWAY 96 W STE 130, SHOREVIEW, MN 55126-1996
(651) 252-1912
Mailing address
470 HIGHWAY 96 W STE 130, SHOREVIEW, MN 55126-1996
(651) 252-1912
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7163
MN
Other
Enumeration date
12/29/2023
Last updated
01/01/2025
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