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General NPI Number Information
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NPI Number | 1760250302
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Entity Type | Individual
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Provider Name | HEATHER MARIE DRAXLER DC
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Gender | Female
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Dates
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Enumeration Date | 12/13/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 7447 EGAN DR STE 201
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City | SAVAGE
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State | MN
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Zip | 55378-3303
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Country | US
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Telephone | 952-447-3343
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Fax |
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Provider Business Mailing Address
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Address Line | 7206 W 114TH STREET CIR
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City | BLOOMINGTON
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State | MN
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Zip | 55438-2803
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Country | US
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Telephone | 952-797-2570
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 4002
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License Number State | MN
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