Healthcare Provider Details

I. General information

NPI: 1992879530
Provider Name (Legal Business Name): LAURA LYNNE HJORT D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 NORMAN AVE S
FOLEY MN
56329-8767
US

IV. Provider business mailing address

130 NORMAN AVE S
FOLEY MN
56329-8767
US

V. Phone/Fax

Practice location:
  • Phone: 320-968-7413
  • Fax: 320-968-7469
Mailing address:
  • Phone: 320-968-7413
  • Fax: 320-968-7469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number4434
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: