Organization
ART DISTRICT CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORI LYNN POTTEBAUM D.C. (CHIEF MANAGER/CHIROPRACTOR)
(612) 741-2736
Entity
Organization
Contact information
Practice address
208 13TH AVE NE, MINNEAPOLIS, MN 55413-4598
(612) 741-2736
Mailing address
208 13TH AVE NE, MINNEAPOLIS, MN 55413-4598
(612) 741-2736
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4083
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
451804700
—
MN
Enumeration date
05/03/2011
Last updated
05/03/2011
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