Individual
DR. JASON OWEN WALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4717 HIAWATHA AVE, MINNEAPOLIS, MN 55406-3928
(612) 721-2146
Mailing address
4717 HIAWATHA AVE, MINNEAPOLIS, MN 55406-3928
(612) 721-2146
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3838
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55F56BL
BCBS
MN
Enumeration date
01/24/2007
Last updated
07/08/2007
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