Healthcare Provider Details

I. General information

NPI: 1669333902
Provider Name (Legal Business Name): CDM, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 PENN AVE S STE 580A
BLOOMINGTON MN
55431-1358
US

IV. Provider business mailing address

9244 RUSSELL AVE S
BLOOMINGTON MN
55431-2122
US

V. Phone/Fax

Practice location:
  • Phone: 952-213-4008
  • Fax:
Mailing address:
  • Phone: 320-905-2072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: CASSIE MCGUIRE
Title or Position: PRESIENT
Credential: DC
Phone: 320-905-2072