Organization
BOULEVARD CHIROPRACTIC CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD ALAN PAULSON D.C. (MANAGER)
(952) 925-4847
Entity
Organization
Contact information
Practice address
7200 MINNETONKA BLVD, ST LOUIS PARK, MN 55426-3210
(952) 925-4847
(952) 925-4211
Mailing address
7200 MINNETONKA BLVD, ST LOUIS PARK, MN 55426-3210
(952) 925-4847
(952) 925-4211
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
1266
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
479324200
—
MN
Enumeration date
10/19/2006
Last updated
12/09/2013
Update your record
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