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General NPI Number Information
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NPI Number | 1104635697
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Entity Type | Individual
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Provider Name | CONNOR THELEMANN DC
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Gender | Male
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 2501 W 84TH ST
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City | BLOOMINGTON
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State | MN
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Zip | 55431-1602
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Country | US
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Telephone | 952-432-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 15696 FINEWOOD CT
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City | APPLE VALLEY
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State | MN
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Zip | 55124-5810
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Country | US
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Telephone | 952-297-5188
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 7284
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License Number State | MN
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