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General NPI Number Information
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NPI Number | 1740325299
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Entity Type | Organization
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Legal Business Name | KENDRICK CHIROPRACTIC CLINIC LTD.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 21080 OLINDA TRL N BOX 4
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City | SCANDIA
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State | MN
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Zip | 55073-9492
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Country | US
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Telephone | 651-433-5750
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Fax | 651-433-5750
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Provider Business Mailing Address
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Address Line | 21080 OLINDA TRL N BOX 4
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City | SCANDIA
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State | MN
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Zip | 55073-9492
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Country | US
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Telephone | 651-433-5750
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Fax | 651-433-5750
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. LELAND JAMES KENDRICK
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Credential | DC
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Telephone | 651-433-5750
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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 | 1508
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License Number State | MN
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