Organization
SDS GROUP PA
Active
Parent organization
SDS GROUP PA
Other names
Chiropractors of St. Anthony / Northeast
Organization subpart
Yes
Provider details
NPI number
Legal business name
SDS GROUP PA
Authorized official
DR. SCOTT DAVID SALITA DC (PRESIDENT)
(612) 991-3139
Entity
Organization
Contact information
Practice address
4833 MINNETONKA BLVD, ST LOUIS PARK, MN 55416-2214
Mailing address
3813 PLYMOUTH RD, MINNETONKA, MN 55305-5001
(612) 991-3139
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4370
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1065328
BCBS CLINIC ID
MN
01
—
119H8CH
BCBS MN ID#
MN
05
—
787250000
—
MN
Enumeration date
02/11/2008
Last updated
09/28/2023
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