Organization
BOLEN CHIROPRACTIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TROY CHRISTOPHER BOLEN D.C. (DOCTOR OF CHIROPRACTIC/ PRESIDENT)
(218) 728-3630
Entity
Organization
Contact information
Practice address
2730 PIEDMONT AVE, DULUTH, MN 55811-6710
(218) 728-3630
(218) 786-0399
Mailing address
2730 PIEDMONT AVE, DULUTH, MN 55811-6710
(218) 728-3630
(218) 786-0399
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3323
MN
111N00000X
Chiropractor
5673
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023379526
—
MN
05
—
1023379526
—
WI
01
—
350005070
MEDICARE PART B
MN
05
—
38911400
—
WI
01
—
5C086BO
BCBSMN
MN
05
—
838818100
—
MN
Enumeration date
07/30/2007
Last updated
07/16/2012
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