NPI | 1992909998 |
---|---|
Doing Business As | BLOOM LAKE CHIROPRACTIC |
Entity Type | Organization |
Authorized Contact | JASON SMITH Owner 612-721-1820 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MN 3356) |
Enumeration Date | 2007-06-13 |
Last Update Date | 2020-08-22 |