Healthcare Provider Details

I. General information

NPI: 1578483848
Provider Name (Legal Business Name): TWIN CITIES FUNCTIONAL NEUROLOGY & CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6543 BLUEBIRD DR
MAPLE GROVE MN
55369-6009
US

IV. Provider business mailing address

6543 BLUEBIRD DR
MAPLE GROVE MN
55369-6009
US

V. Phone/Fax

Practice location:
  • Phone: 715-417-0687
  • Fax:
Mailing address:
  • Phone: 715-417-0687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: RILEY EDLING
Title or Position: OWNER
Credential: DC, DACNB
Phone: 715-417-0687