Individual
JEFFREY ALLEN EWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2501 W 84TH ST, BLOOMINGTON, MN 55431-1602
(952) 888-4777
Mailing address
2501 W 84TH ST, BLOOMINGTON, MN 55431-1602
(952) 888-4777
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
1742
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
812727100
—
MN
Enumeration date
07/15/2008
Last updated
07/15/2008
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