Individual
JACOB B GUNDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, ATC
Contact information
Practice address
19260 EVANS ST NW, ELK RIVER, MN 55330-1076
(763) 441-7788
Mailing address
19260 EVANS ST NW, ELK RIVER, MN 55330-1076
(763) 441-7788
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7215
MN
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
01/03/2019
Last updated
02/29/2024
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