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NPI Code Detail

MEDICARE: DR. EMILEE MYTINGER DC

MEDICARE:  DR. EMILEE  MYTINGER  DC
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
1111N00000XChiropractor6985MN

General Provider Information

NPI Number : 1013648856
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILEE MYTINGER DC
Provider Business Mailing Address
First Line : 7492 W 78TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55439-2513
Country : US
Telephone Number : 952-255-6980
Fax Number :
Provider Business Practice Location Address
First Line : 7492 W 78TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55439-2513
Country : US
Telephone Number : 952-255-6980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2022
Last Update Date : 11/10/2022

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Directions to “ DR. EMILEE MYTINGER DC” Practice Location

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