Organization
MAHTOMEDI NATURAL CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GINA FIALA (DR. GINA FIALA)
(651) 407-0802
Entity
Organization
Contact information
Practice address
1526 MAHTOMEDI AVE, MAHTOMEDI, MN 55115
(651) 407-0802
(651) 407-0812
Mailing address
1526 MAHTOMEDI AVE, MAHTOMEDI, MN 55115
(651) 407-0802
(651) 407-0812
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
MN4887
MN
111N00000X
Chiropractor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
996697000
—
MN
Enumeration date
01/10/2007
Last updated
03/16/2010
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