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General NPI Number Information
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NPI Number | 1710085576
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Entity Type | Individual
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Provider Name | LOWELL PETER MAGELSSEN D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1042 HIGHWAY 96 W
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City | SHOREVIEW
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State | MN
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Zip | 55126-1913
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Country | US
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Telephone | 651-482-1040
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Fax | 651-482-8398
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Provider Business Mailing Address
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Address Line | 1042 HIGHWAY 96 W
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City | SHOREVIEW
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State | MN
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Zip | 55126-1913
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Country | US
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Telephone | 651-482-1040
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Fax | 651-482-8398
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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 | 2067
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3932
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1916-012
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License Number State | WI
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