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Individual

MR. ROBERT T THIRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1608 W 155TH ST, BURNSVILLE, MN 55306-5308
(612) 695-4890
Mailing address
PO BOX 3047, BURNSVILLE, MN 55337-8047
(612) 695-4890

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1472
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
29064TH
BLUE CROSS BLUE SHIELD
MN
Enumeration date
12/17/2006
Last updated
12/09/2013
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