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General NPI Number Information
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NPI Number | 1407985872
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Entity Type | Organization
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Legal Business Name | FERNBROOK CHIRPRACTIC, LTD.
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Dates
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Enumeration Date | 03/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3169 FERNBROOK LN N
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City | PLYMOUTH
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State | MN
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Zip | 55447-5357
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Country | US
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Telephone | 763-201-1284
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Fax | 763-201-1285
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Provider Business Mailing Address
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Address Line | 3169 FERNBROOK LN N
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City | PLYMOUTH
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State | MN
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Zip | 55447-5357
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Country | US
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Telephone | 763-201-1284
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Fax | 763-201-1285
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Authorized Official
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Title or Position | OWNER
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Name | DR. DEAN CLARENCE SAUNDERS
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Credential | D.C.
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Telephone | 763-201-1284
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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 | 3304
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License Number State | MN
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