Individual
DR. JUSTIN LEE THIELKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
9325 UPLAND LN N STE 230, MAPLE GROVE, MN 55369-4450
(763) 315-0466
Mailing address
9325 UPLAND LN N STE 230, MAPLE GROVE, MN 55369-4450
(763) 315-0466
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4791
MN
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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