Individual
BETHANIE ROUE MELLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
101 LAKE ST W, WAYZATA, MN 55391-1576
(952) 473-1773
Mailing address
15259 FLORIST CIR, APPLE VALLEY, MN 55124-4006
(651) 274-8300
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7036
MN
Other
Enumeration date
01/03/2023
Last updated
02/27/2023
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