Organization
EAGLE TRACE WELLNESS CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELISA MARIE KENSINGER D.C. (VICE PRESIDENT, SECRETARY, TREASURE)
(952) 808-2922
Entity
Organization
Contact information
Practice address
12002 COUNTY ROAD 11, BURNSVILLE, MN 55337-3016
(952) 808-2922
(952) 808-2910
Mailing address
12002 COUNTY ROAD 11, BURNSVILLE, MN 55337-3016
(952) 808-2922
(952) 808-2910
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5077
MN
111N00000X
Chiropractor
5104
MN
171100000X
Acupuncturist
832
MN
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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