Individual
DR. MAUDIE RAE LOUISIANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
103 CENTER DR, SUITE 200, BUFFALO, MN 55313-2957
(763) 682-0611
(763) 682-0788
Mailing address
103 CENTER DR, SUITE 200, BUFFALO, MN 55313-2957
(763) 682-0611
(763) 682-0788
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC 3992
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
064G0LO
BLUE CROSS BLUE SHIELD
MN
Enumeration date
02/14/2007
Last updated
07/08/2007
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