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Individual

DR. DUSTIN PAUL CARLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
4717 CLARK AVE, WHITE BEAR LAKE, MN 55110-3221
(651) 762-8040
(651) 762-8070
Mailing address
4717 CLARK AVE, WHITE BEAR LAKE, MN 55110-3221
(651) 762-8040
(651) 762-8070

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4394
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
599S5CA
BLUE CROSS IPN
MN
05
614970700
MN
01
94027
HEALTHPARTNERS PIN
MN
Enumeration date
10/10/2006
Last updated
06/22/2016
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