Organization
SHOREVIEW SPINE AND SPORT FAMILY CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD LEROY HENDRICKSON DC (PRESIDENT/TREASURER/SECRETARY)
(218) 205-0387
Entity
Organization
Contact information
Practice address
3434 LEXINGTON AVE N, SUITE 900, SHOREVIEW, MN 55126-8069
(651) 447-2468
Mailing address
3434 LEXINGTON AVE N, SUITE 900, SHOREVIEW, MN 55126-8069
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5736
MN
Other
Enumeration date
01/02/2013
Last updated
01/26/2013
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