| NPI | 1639373319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY MARIE SMITH Owner Chiropractor 651-405-3990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 4141) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN K331197590107) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-08-22 |