Organization
AFTON CHIROPRACTIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIE Q CAULDER D.C. (PRESIDENT)
(651) 436-7757
Entity
Organization
Contact information
Practice address
44 SAINT CROIX TRL S, SUITE 200, LAKELAND, MN 55043-8404
(651) 436-7757
Mailing address
44 SAINT CROIX TRL S, SUITE 200, LAKELAND, MN 55043-8404
(651) 436-7757
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
171100000X
Acupuncturist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200967600
—
MN
01
—
38962900
BADGERCARE
WI
01
—
38963000
BADGERCARE
WI
05
—
618323900
—
MN
01
—
97G19CA
BCBS
MN
01
—
98D84QU
BCBS
MN
Enumeration date
06/13/2007
Last updated
09/05/2013
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