Healthcare Provider Details

I. General information

NPI: 1205035524
Provider Name (Legal Business Name): HEAD TO TOE CHIROPRACTIC CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W FRANKLIN AVE
MINNEAPOLIS MN
55404-2331
US

IV. Provider business mailing address

9940 PENN AVE S APT 5
BLOOMINGTON MN
55431-2928
US

V. Phone/Fax

Practice location:
  • Phone: 612-616-5452
  • Fax:
Mailing address:
  • Phone: 612-616-5452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number3958
License Number StateMN

VIII. Authorized Official

Name: DR. LINDA J. DOBBERSTEIN
Title or Position: CHIROPRACTOR/OWNER
Credential: DC, DACBN
Phone: 612-616-5452