Organization
DIANNE L. COMO, DC, PA
Active
Organization
DIANNE L. COMO, DC, PA
Active
Other names
Back in Shape Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANNE L. COMO D.C. (OWNER/PRESIDENT/CHIROPRACTOR)
(763) 595-9096
Entity
Organization
Contact information
Practice address
669 WINNETKA AVE N, SUITE 202, GOLDEN VALLEY, MN 55427-4574
(763) 595-9096
(763) 595-0291
Mailing address
669 WINNETKA AVE N, SUITE 202, GOLDEN VALLEY, MN 55427-4574
(763) 595-9096
(763) 595-0291
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
3191
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55F12CO
BCBS
MN
05
—
889027700
—
MN
Enumeration date
09/20/2006
Last updated
08/19/2008
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