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Individual

DR. EDWIN MONETTE FISSINGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
6550 YORK AVE S, SUITE 515, EDINA, MN 55435-2347
(952) 926-7515
(952) 926-8155
Mailing address
6550 YORK AVE S, SUITE 515, EDINA, MN 55435-2347
(952) 926-7515
(952) 926-8155

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2520
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123
CHIRO SERV
MN
01
3D482FI
BLUE CROSS BLUE SHIELD
MN
01
841828400
MINNESOTA CARE
MN
Enumeration date
02/08/2007
Last updated
11/13/2007
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