Organization
PLCC, LTD
Active
Other names
Prior Lake Chiropractic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS LEONARD STICHA D.C (CEO)
(952) 447-8980
Entity
Organization
Contact information
Practice address
14020 HIGHWAY 13 S, SUITE 650, SAVAGE, MN 55378-7100
(952) 447-8980
(952) 447-8941
Mailing address
14020 HIGHWAY 13 S, SUITE 650, SAVAGE, MN 55378-7100
(952) 447-8980
(952) 447-8941
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69944580
—
MN
01
—
75172PR
BLUE CROSS BLUE SHILED
MN
Enumeration date
11/07/2006
Last updated
08/22/2020
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