Individual
DR. JO G THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
8465 W BROADWAY AVE, BROOKLYN PARK, MN 55445-2266
(763) 424-7750
(763) 424-3444
Mailing address
8465 W BROADWAY AVE, BROOKLYN PARK, MN 55445-2266
(763) 424-7750
(763) 424-3444
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2599
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952484602
NPI FACILITY
—
05
—
416728700
—
MN
Enumeration date
10/23/2006
Last updated
02/16/2026
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