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Individual

MS. DIANNE G KROGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
5609 CHICAGO AVE, MINNEAPOLIS, MN 55417-2429
(612) 824-7012
(612) 822-8766
Mailing address
10008 MAPLE CIR, BLOOMINGTON, MN 55431-2870
(612) 388-0454

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2117
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
44-86873
MEDICA
MN
01
54D34KR
BCBS
MN
05
823728000
MN
Enumeration date
01/12/2007
Last updated
09/04/2008
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