Organization
NORTHSIDE CHIROPRACTIC CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREG T OLSON DC (PRESIDENT/CEO)
(612) 522-0440
Entity
Organization
Contact information
Practice address
3107 PENN AVE N, MINNEAPOLIS, MN 55411-1123
(612) 522-0440
(612) 522-1816
Mailing address
3107 PENN AVE N, MINNEAPOLIS, MN 55411-1123
(612) 522-0440
(612) 522-1816
Taxonomy
Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
Primary
2197
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890828100
—
MN
Enumeration date
04/16/2013
Last updated
07/10/2013
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