Organization
ROSEVILLE CHIROPRACTIC CLINIC, LLC
Active
Other names
Sprout Chiropractic & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KAY MASSA (OWNER)
(612) 424-5757
Entity
Organization
Contact information
Practice address
7525 VILLAGE DR STE 110, LINO LAKES, MN 55014-1305
(651) 247-0941
Mailing address
7525 VILLAGE DR STE 110, LINO LAKES, MN 55014-1305
(612) 424-5757
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4755-012
WI
111N00000X
Chiropractor
Primary
5493
MN
Other
Enumeration date
08/11/2011
Last updated
07/18/2022
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