Individual
JANICE A SUPPES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
5757 SANIBEL DR, MINNETONKA, MN 55343
(952) 939-0297
(952) 939-0297
Mailing address
5757 SANIBEL DR, MINNETONKA, MN 55343
(952) 939-0297
(952) 939-0297
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2069MN
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068027300
—
MN
Enumeration date
11/20/2006
Last updated
04/18/2008
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