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Organization

BOLINE CHIROPRACTIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICK D BOLINE (OWNER)
(218) 631-3003
Entity
Organization

Contact information

Practice address
11 BRYANT AVE SW, WADENA, MN 56482-1405
(218) 631-3003
Mailing address
11 BRYANT AVE SW, WADENA, MN 56482-1405
(218) 631-3003

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
002485
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
230981
CHIROCARE
MN
01
3C907BO
BCBS
MN
01
HP21779
HEALTH PARTNERS
MN
Enumeration date
09/28/2006
Last updated
01/08/2008
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