Individual
KAYLA MIDDENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1777 BUNKER LAKE BLVD NW # 200, ANDOVER, MN 55304-4008
(763) 413-6934
Mailing address
4251 W 125TH ST, SAVAGE, MN 55378-1413
(320) 429-0044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6652
MN
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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