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General NPI Number Information
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NPI Number | 1164608089
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Entity Type | Organization
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Legal Business Name | CIRCLE OF LIFE CHIROPRACTIC
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 31 W SUPERIOR ST SUITE 501
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City | DULUTH
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State | MN
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Zip | 55802-2063
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Country | US
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Telephone | 218-740-3379
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Fax | 218-740-3380
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Provider Business Mailing Address
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Address Line | 31 W SUPERIOR ST SUITE 501
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City | DULUTH
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State | MN
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Zip | 55802-2063
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Country | US
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Telephone | 218-740-3379
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Fax | 218-740-3380
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. CLAUDIA CARLSON COTTRELL
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Credential | D.C.
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Telephone | 218-740-3379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 2990
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License Number State | MN
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