Organization
FORTIN HEALTH & WELLNESS CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA KAREN FORTIN DC (OWNER/CHIROPRACTOR)
(763) 478-3978
Entity
Organization
Contact information
Practice address
149 HAMEL ROAD, HAMEL, MN 55340
(763) 478-3978
(763) 478-3502
Mailing address
PO BOX 271, HAMEL, MN 55340-0271
(763) 478-3978
(763) 478-3502
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4147
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08154FO
GROUP/CLINIC
MN
01
—
081G5FO
BCBS INDIVIDUAL
MN
Enumeration date
08/20/2006
Last updated
08/22/2020
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