Individual
DR. GERALD THOMAS LALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
520 HIGHWAY 96 W, SUITE 200, SHOREVIEW, MN 55126-3202
(651) 484-8521
(651) 484-7374
Mailing address
520 HIGHWAY 96 W, SUITE 200, SHOREVIEW, MN 55126-3202
(651) 484-8521
(651) 484-7374
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1142
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24793LA
BLUECROSS/BLUESHIELD
MN
Enumeration date
07/25/2006
Last updated
01/06/2014
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