MEDICARE: MAXIMUM LIFE, INC.

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
1	111N00000X	Chiropractor	3926	MN

General Provider Information

NPI Number	:	1902086143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXIMUM LIFE, INC.

Provider Business Mailing Address
First Line	:	12486 74TH AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-5285
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8509 JEFFERSON LN N
Second Line	:	SUITE 110
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55445-2119
Country	:	US
Telephone Number	:	763-311-5128
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TROY WENDELL BJORKLUND
Credential	:	D.C.
Telephone Number	:	763-315-1282

Provider Enumeration Date	:	11/05/2007
Last Update Date	:	11/05/2007

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