Organization
CHIROPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKSON LEE D.C. (DOCTOR OF CHIROPRACTIC)
(651) 900-3562
Entity
Organization
Contact information
Practice address
1440 ARCADE ST STE C, SAINT PAUL, MN 55106-1830
(651) 900-3562
Mailing address
1440 ARCADE ST STE C, SAINT PAUL, MN 55106-1830
(651) 900-3562
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6112
MN
Other
Enumeration date
08/18/2015
Last updated
09/22/2015
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