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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