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General NPI Number Information
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NPI Number | 1376204479
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Entity Type | Individual
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Provider Name | KATIE JO KLUNDT DC
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Gender | Female
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Dates
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Enumeration Date | 01/02/2022
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Last Update Date | 04/08/2022
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Provider Practice Location Address
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Address Line | 3948 W 50TH ST STE 203
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City | EDINA
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State | MN
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Zip | 55424-1253
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Country | US
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Telephone | 952-920-4528
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Fax |
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Provider Business Mailing Address
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Address Line | 15551 DUNRAVEN DR
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City | APPLE VALLEY
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State | MN
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Zip | 55124-7838
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Country | US
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Telephone | 952-920-4528
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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 | 6936
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License Number State | MN
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