Organization
RESTORATIVE LASER THERAPY L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL FOREST (OWNER)
(651) 323-8954
Entity
Organization
Contact information
Practice address
116 CHESTNUT ST E, STILLWATER, MN 55082-5116
(651) 323-8954
Mailing address
116 CHESTNUT ST E, STILLWATER, MN 55082-5116
(651) 323-8954
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6060
MN
Other
Enumeration date
03/12/2015
Last updated
03/12/2015
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