Individual
MR. ROBERT DONALD WADDELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
12099 LAKE BLVD, LINDSTROM, MN 55045
(651) 257-1103
(651) 257-1552
Mailing address
12099 LAKE BLVD, LINDSTROM, MN 55045
(651) 257-1103
(651) 257-1552
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1473
MN
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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