Organization
SUPPES ENTERPRISES, INC.
Active
Other names
Janice A Suppes, DC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANICE A SUPPES D.C. (PRESIDENT)
(952) 939-0297
Entity
Organization
Contact information
Practice address
5757 SANIBEL DR, SUITE 11, MINNETONKA, MN 55343-4110
(952) 939-0297
Mailing address
5757 SANIBEL DR, SUITE 11, MINNETONKA, MN 55343-4110
(952) 939-0297
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2069
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068027300
MEDICAL ASSISTANCE
MN
01
—
350000228
PTAN
MN
Enumeration date
02/06/2013
Last updated
02/06/2013
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