| NPI | 1215127808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY CHRISTOPHER BOLEN Doctor Of Chiropractic/ President 218-728-3630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 3323) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 5673) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2012-07-16 |