Individual
DR. BLAKE R DEJONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14675 MARTIN DR STE 100, EDEN PRAIRIE, MN 55344-2016
(952) 797-3045
Mailing address
14675 MARTIN DR STE 100, EDEN PRAIRIE, MN 55344-2016
(952) 797-3045
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6850
MN
Other
Enumeration date
03/04/2022
Last updated
03/04/2022
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