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General NPI Number Information
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NPI Number | 1639963127
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Entity Type | Individual
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Provider Name | CECILEY JEANNE MAXA DC
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Gender | Female
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 6001 EGAN DR STE 120
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City | SAVAGE
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State | MN
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Zip | 55378-4910
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Country | US
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Telephone | 952-440-4553
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Fax | 952-440-4573
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Provider Business Mailing Address
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Address Line | 13914 LUPINE TRL NE
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City | PRIOR LAKE
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State | MN
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Zip | 55372-2884
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Country | US
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Telephone | 715-220-8004
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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 | 7322
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License Number State | MN
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