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General NPI Number Information
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NPI Number | 1366990616
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Entity Type | Organization
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Legal Business Name | LIVING STRONG CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 09/15/2016
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Last Update Date | 09/15/2016
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Provider Practice Location Address
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Address Line | 800 MINNEHAHA AVE E SUITE 355
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City | SAINT PAUL
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State | MN
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Zip | 55106-4437
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Country | US
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Telephone | 651-780-7227
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Fax |
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Provider Business Mailing Address
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Address Line | 800 MINNEHAHA AVE E SUITE 355
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City | SAINT PAUL
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State | MN
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Zip | 55106-4437
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Country | US
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Telephone | 651-780-7227
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAO VANG VU
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Credential | D.C.
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Telephone | 651-780-7227
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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 | 1550
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License Number State | MN
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