Healthcare Provider Details

I. General information

NPI: 1619168200
Provider Name (Legal Business Name): BOSCHEE CHIROPRACTIC, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 NORMANDALE BLVD
BLOOMINGTON MN
55437-2700
US

IV. Provider business mailing address

12300 SINGLETREE LANE
EDEN PRAIRIE MN
55344
US

V. Phone/Fax

Practice location:
  • Phone: 952-888-5805
  • Fax: 952-888-7563
Mailing address:
  • Phone: 952-888-5805
  • Fax: 952-903-2816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number003458
License Number StateMN

VIII. Authorized Official

Name: DR. TROY ALLEN BOSCHEE
Title or Position: OWNER
Credential: D.C.
Phone: 952-888-5805