Organization
FOUR SEASONS FAMILY CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BRADLEY SHINDER (DC)
(763) 557-9032
Entity
Organization
Contact information
Practice address
4455 HWY 169 N, STE 200, PLYMOUTH, MN 55442
(763) 557-9032
(763) 557-9838
Mailing address
4455 HWY 169 N, STE 200, PLYMOUTH, MN 55442
(763) 557-9032
(763) 557-9838
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2411
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191028100
—
MN
01
—
350002447
MEDICARE
MN
01
—
60627FO
BCBS
MN
Enumeration date
05/16/2007
Last updated
04/29/2010
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