Healthcare Provider Details

I. General information

NPI: 1295500536
Provider Name (Legal Business Name): CAYDEN HARE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 UNIVERSITY AVE W STE 306
SAINT PAUL MN
55104-3922
US

IV. Provider business mailing address

14249 BANYAN LN
ROSEMOUNT MN
55068-3494
US

V. Phone/Fax

Practice location:
  • Phone: 651-209-6060
  • Fax: 651-209-6063
Mailing address:
  • Phone: 701-269-4383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7143
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: