Organization
NORTHSTAR CHIROPRACTIC & WELLNESS, P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN ERIK DAVIDSON D. C. (OWNER)
(763) 263-8433
Entity
Organization
Contact information
Practice address
670 HUMBOLDT DR, BIG LAKE, MN 55309-9407
(763) 263-8433
(763) 263-2963
Mailing address
670 HUMBOLDT DR, PO BOX 88, BIG LAKE, MN 55309-9407
(763) 263-8433
(763) 263-2963
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3099
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300463500
—
MN
Enumeration date
10/13/2010
Last updated
10/13/2010
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