Organization
ARDENVIEW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HEAD (OWNER/CHIROPRACTOR)
(651) 447-2468
Entity
Organization
Contact information
Practice address
3434 LEXINGTON AVE N, SHOREVIEW, MN 55126-8069
(651) 447-2468
Mailing address
3434 LEXINGTON AVE N, SHOREVIEW, MN 55126-8069
(651) 447-2468
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3281
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35P23HE
BCBS OF MN INDIVIDUAL ID
MN
05
—
7711328-00
—
MN
Enumeration date
02/11/2015
Last updated
02/11/2015
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