Organization
PEDDYCOART CHIROPRACTIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENWYN ANNE-LISA PEDDYCOART D.C. (PRESIDENT)
(651) 770-8424
Entity
Organization
Contact information
Practice address
1803 BUERKLE RD, SUITE 101, WHITE BEAR LAKE, MN 55110-5269
(651) 770-8424
(651) 770-3170
Mailing address
1803 BUERKLE RD, SUITE 101, WHITE BEAR LAKE, MN 55110-5269
(651) 770-8424
(651) 770-3170
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3350
MN
Other
Enumeration date
09/17/2010
Last updated
09/17/2010
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