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NPI Code Detail

MEDICARE: DR. TROY WILLIAM TVEDT II D.C.

MEDICARE: DR. TROY WILLIAM TVEDT II D.C.
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
1111N00000XChiropractor4277MN

General Provider Information

NPI Number : 1225034127
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TROY WILLIAM TVEDT II D.C.
Provider Business Mailing Address
First Line : 114C SOUTH DR
Second Line :
City : CIRCLE PINES
State : MN
Zip : 55014-3312
Country : US
Telephone Number : 763-792-1896
Fax Number :
Provider Business Practice Location Address
First Line : 703 THIELEN DR
Second Line :
City : SAINT MICHAEL
State : MN
Zip : 55376-9613
Country : US
Telephone Number : 763-497-1152
Fax Number : 763-497-5256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 07/08/2007

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