Individual
DR. PAUL JEFFREY DETTLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
615 66TH AVE N, BROOKLYN CENTER, MN 55430-1667
(763) 560-8980
Mailing address
615 66TH AVE N STE 2, BROOKLYN CENTER, MN 55430-1666
(763) 560-8980
(763) 560-0611
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
6125
MN
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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