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Organization

FAMILY CHIROPRACTIC OF SHAKOPEE, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN LESLIE HARDER D.C. (PRESIDENT)
(952) 445-0679
Entity
Organization

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
01
4C223FA
BCBS PROVIDER CLINIC NO
MN
05
512718100
MN
Enumeration date
02/16/2010
Last updated
02/22/2010
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