Organization
ELITE CHIROPRACTIC-NORTH ST. PAUL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY DALE WILDBERG D.C. (OWNER, PRESIDENT OF LLC)
(952) 492-5914
Entity
Organization
Contact information
Practice address
2597 7TH AVE E, SAINT PAUL, MN 55109-3104
(651) 777-1710
(651) 777-9108
Mailing address
20456 LAKE RIDGE DR, PRIOR LAKE, MN 55372-7805
(952) 492-5914
(952) 492-5913
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
07/14/2006
Last updated
08/22/2020
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