| NPI | 1053560292 |
|---|---|
| Doing Business As | PROACTIVE CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | NATE BURDASH Owner 651-778-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |