Individual
DR. MICHAEL LAVERN MARISTUEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2216 COUNTY ROAD D W, SUITE B, SAINT PAUL, MN 55112-7500
(651) 639-1066
(651) 639-1069
Mailing address
2216 COUNTY ROAD D W, SUITE B, SAINT PAUL, MN 55112-7500
(651) 639-1066
(651) 639-1069
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4409
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
318G5SP
BLUECROSS BLUESHIELD
MN
Enumeration date
05/16/2007
Last updated
08/16/2021
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