Healthcare Provider Details

I. General information

NPI: 1386802437
Provider Name (Legal Business Name): WOLFF CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5332 46TH AVE S
MINNEAPOLIS MN
55417-2308
US

IV. Provider business mailing address

5332 46TH AVE SO
MINNEAPOLIS MN
55417-2308
US

V. Phone/Fax

Practice location:
  • Phone: 651-402-2914
  • Fax:
Mailing address:
  • Phone: 651-402-2914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4965
License Number StateMN

VIII. Authorized Official

Name: DR. PATRICIA A WOLFF
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 651-402-2914