Organization
CHIROPRACTIC REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE JEROD CRANE DC (OWNER CEO)
(651) 734-1123
Entity
Organization
Contact information
Practice address
9900 VALLEY CREEK RD #145, WOODBURY, MN 55125
(651) 734-1123
(651) 734-1109
Mailing address
9900 VALLEY CREEK RD #145, WOODBURY, MN 55125
(651) 734-1123
(651) 734-1109
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3831
MN
111N00000X
Chiropractor
4269
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
97D66CH
BLUE CROSS BLUE SHIELD
MN
Enumeration date
01/09/2007
Last updated
08/22/2020
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