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General NPI Number Information
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NPI Number | 1962724104
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Entity Type | Organization
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Legal Business Name | OAKWOOD CHIROPRACTIC CLINIC, INC.
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Dates
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Enumeration Date | 02/15/2010
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Last Update Date | 06/18/2015
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Provider Practice Location Address
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Address Line | 1355 GENEVA AVE N SUITE 100
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City | OAKDALE
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State | MN
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Zip | 55128-5706
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Country | US
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Telephone | 651-735-4140
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Fax | 651-735-8145
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Provider Business Mailing Address
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Address Line | 1355 GENEVA AVE N SUITE 100
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City | OAKDALE
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State | MN
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Zip | 55128-5706
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Country | US
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Telephone | 651-735-4140
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Fax | 651-735-8145
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS G HARDEN
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Credential | D.C.
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Telephone | 651-735-4140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 1487
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License Number State | MN
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