Organization
EATON SPORT AND SPINE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY CHARLES EATON D.C. (OWNER)
(612) 701-2246
Entity
Organization
Contact information
Practice address
424 BRIDGE AVE, SUITE 3, ALBERT LEA, MN 56007-2949
(612) 701-2246
Mailing address
424 BRIDGE AVE, SUITE 3, ALBERT LEA, MN 56007-2949
(612) 701-2246
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4907
MN
Other
Enumeration date
03/27/2009
Last updated
03/27/2009
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