Organization
GRAND AVENUE CHIROPRACTIC & ACUPUNCTURE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTEN MODDRELL D.C. (OWNER)
(651) 222-7381
Entity
Organization
Contact information
Practice address
976 GRAND AVE, SAINT PAUL, MN 55105-3014
(651) 222-7381
Mailing address
976 GRAND AVE, SAINT PAUL, MN 55105-3014
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5315
MN
Other
Enumeration date
01/11/2010
Last updated
01/17/2017
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