Organization
SPINE AND SPORTS INSITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER LEE LACHNER (OFFICE MANAGER)
(763) 315-0466
Entity
Organization
Contact information
Practice address
9325 UPLAND LN N, SUITE 230, MAPLE GROVE, MN 55369-4200
(763) 315-0466
(763) 315-0884
Mailing address
9325 UPLAND LN N, SUITE 230, MAPLE GROVE, MN 55369-4200
(763) 315-0466
(763) 315-0884
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
—
MN
Other
Enumeration date
12/27/2007
Last updated
04/20/2008
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