Individual
CAROLYN OHARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11254 86TH AVE N, MAPLE GROVE, MN 55369-4510
(763) 494-0090
Mailing address
11254 86TH AVE N, MAPLE GROVE, MN 55369-4510
(763) 494-0090
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3886
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
244T20H
BCBS
MN
01
—
P00286533
RAILROAD MEDICARE
MN
Enumeration date
08/31/2006
Last updated
01/08/2008
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