Organization
BANDANA CHIROPRACTIC AND WELLNESS CENTER PA
Active
Parent organization
BANDANA CHIROPRACTIC AND WELLNESS CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANDANA CHIROPRACTIC AND WELLNESS CENTER
Authorized official
MS. ANDREA GAYLE REINHART (OFFICE MANAGER)
(651) 646-2050
Entity
Organization
Contact information
Practice address
1912 LEXINGTON AVE N, SUITE 250, ROSEVILLE, MN 55113-6113
(651) 646-2050
Mailing address
1912 LEXINGTON AVE N, SUITE 250, ROSEVILLE, MN 55113-6113
(651) 646-2050
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3815
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
76D38BA
BLUE CROSS BLUE SHIELD PROVIDER ID
MN
Enumeration date
06/09/2008
Last updated
01/03/2018
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