Individual
MRS. SHELLY MARIE SMITH RECER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
3440 FEDERAL DR, SUITE 120, EAGAN, MN 55122-3501
(651) 405-3990
(651) 403-5643
Mailing address
3440 FEDERAL DR, SUITE 120, EAGAN, MN 55122-3501
(651) 405-3990
(651) 403-5643
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
003434
MN
111N00000X
Chiropractor
Primary
3434
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10G29SM
BCBS
MN
05
—
442415000
—
MN
05
—
716342800
—
MN
Enumeration date
04/10/2007
Last updated
04/05/2012
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