Organization
SPINE CARE SPECIALISTS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE E DAHL D.C. (PRESIDENT)
(763) 780-4300
Entity
Organization
Contact information
Practice address
7699 HIGHWAY 65 NE, FRIDLEY, MN 55432-3525
(763) 780-4300
(763) 780-3789
Mailing address
7699 HIGHWAY 65 NE, FRIDLEY, MN 55432-3525
(763) 780-4300
(763) 780-3789
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01396
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01396
CHIROPRACTIC LICENSE
MN
Enumeration date
06/18/2012
Last updated
06/18/2012
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