Organization
ROOTS CHIROPRACTIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LASHONDA JUNG DC (CHIROPRACTOR/CO OWNER)
(701) 320-0853
Entity
Organization
Contact information
Practice address
8112 MINNETONKA BLVD, ST LOUIS PARK, MN 55426-3022
(952) 229-4520
Mailing address
8112 MINNETONKA BLVD, ST LOUIS PARK, MN 55426-3022
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6586
NON PARTICIPATING
MN
01
—
6600
NON PARTICIPATING
MN
Enumeration date
09/02/2020
Last updated
09/02/2020
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