Individual
DR. JEFFREY KYLE ELLIOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6550 YORK AVE S, SUITE 515, MINNEAPOLIS, MN 55435-2347
(952) 210-9310
(952) 926-8155
Mailing address
936 WATERFORD DR E, EAGAN, MN 55123-1932
(651) 230-5355
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4474-12
WI
111N00000X
Chiropractor
Primary
5164
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11989599
CAQH
WI
Enumeration date
02/23/2009
Last updated
04/12/2021
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