Individual
DR. RENA ANN WIDBOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
2112 LYNDALE AVE S, MINNEAPOLIS, MN 55405-3026
(612) 874-1313
Mailing address
13605 27TH AVE N, PLYMOUTH, MN 55441-3616
(763) 559-5326
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5145
MN
Other
Enumeration date
11/04/2008
Last updated
11/26/2012
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