Individual
DR. SHANE ALEX BORODITSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12000 ELM CREEK BLVD N, SUITE L70, MAPLE GROVE, MN 55369-7073
(612) 281-3575
(612) 605-8257
Mailing address
PO BOX 582774, MINNEAPOLIS, MN 55458-2774
(612) 281-3575
(612) 605-8257
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3976
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110238
HEALTH PARTNERS
MN
01
—
329G7BO
BLUE CROSS / BLUE SHIELD
MN
01
—
44-50913
MEDICA
MN
Enumeration date
08/20/2006
Last updated
07/08/2007
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