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NPI Code Detail

MEDICARE: DR. LISA VERNA D.C.

MEDICARE: DR. LISA VERNA D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor4610MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104965656
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA VERNA D.C.
Provider Business Mailing Address
First Line : 1730 PLYMOUTH RD STE 300
Second Line :
City : MINNETONKA
State : MN
Zip : 55305-1932
Country : US
Telephone Number : 952-300-2387
Fax Number : 952-300-2386
Provider Business Practice Location Address
First Line : 4833 MINNETONKA BLVD
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55416-2214
Country : US
Telephone Number : 952-913-8687
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2007
Last Update Date : 06/18/2012

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Directions to “ DR. LISA VERNA D.C.” Practice Location

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