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General NPI Number Information
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NPI Number | 1639179625
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Entity Type | Individual
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Provider Name | JUDITH ANN ST. CLAIR D.C.
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Gender | Female
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Dates
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Enumeration Date | 07/31/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 7400 LYNDALE AVE S #190
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City | RICHFIELD
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State | MN
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Zip | 55423-4055
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Country | US
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Telephone | 612-869-7371
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Fax | 612-869-2761
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Provider Business Mailing Address
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Address Line | 7400 LYNDALE AVE S
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City | RICHFIELD
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State | MN
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Zip | 55423-4142
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Country | US
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Telephone | 612-869-7371
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Fax | 612-869-2761
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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 | 1768
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License Number State | MN
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