Organization
PRIOR LAKE SPINE HEALTH & INJURY CENTER, PLLC
Active
Other names
Prior Lake Spine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA R RICKERT (OWNER/CEO)
(952) 226-5100
Entity
Organization
Contact information
Practice address
16197 MAIN AVE SE, PRIOR LAKE, MN 55372-1704
(952) 226-5100
(952) 516-5240
Mailing address
16197 MAIN AVE SE, PRIOR LAKE, MN 55372-1704
(952) 226-5100
(952) 516-5240
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5230
MN
Other
Enumeration date
11/08/2011
Last updated
07/27/2012
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