Individual
DR. JOHN LESLIE HARDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1221 4TH AVE E, SUITE 120, SHAKOPEE, MN 55379-1681
(952) 445-0679
(952) 445-6979
Mailing address
1221 4TH AVE E, SUITE 120, SHAKOPEE, MN 55379-1681
(952) 445-0679
(952) 445-6979
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3128
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053537
—
MN
01
—
4C223FA
BCBS PROVIDER CLINIC NO.
MN
01
—
4C765HA
BCBS INDIV. PROVIDER NO.
MN
Enumeration date
04/17/2007
Last updated
07/09/2007
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