MEDICARE: CLAUSSEN CHIROPRACTIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1911	MN

General Provider Information

NPI Number	:	1013185768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLAUSSEN CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	8441 WAYZATA BLVD
Second Line	:	SUITE 370
City	:	GOLDEN VALLEY
State	:	MN
Zip	:	55426-1344
Country	:	US
Telephone Number	:	952-473-3336
Fax Number	:

Provider Business Practice Location Address
First Line	:	8441 WAYZATA BLVD
Second Line	:	SUITE 370
City	:	GOLDEN VALLEY
State	:	MN
Zip	:	55426-1344
Country	:	US
Telephone Number	:	952-473-3336
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FREDERICK LEWIS CLAUSSEN
Credential	:	DC
Telephone Number	:	952-473-3336

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	02/15/2008

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