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General NPI Number Information
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NPI Number | 1780547406
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Entity Type | Organization
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Legal Business Name | NORDIC REHAB AND CHIROPRACTIC
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 5250 W 74TH ST STE 8
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City | EDINA
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State | MN
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Zip | 55439-2229
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Country | US
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Telephone | 952-479-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 6511 110TH LN N
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City | CHAMPLIN
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State | MN
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Zip | 55316-3856
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, CHIROPRACTOR
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Name | MAGDALENE KAYE KOETHE
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Credential | DC
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Telephone | 763-807-2112
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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 |
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License Number State |
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