MEDICARE: DR. WILLIAM THOMAS NORLIN 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
1	111NS0005X	Sports Physician Chiropractor	001817-3	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12644NO	OTHER	MN	BLUECROSSBLUESHIELD OF MN
2	4480261	OTHER	MN	MEDICA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376689687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM THOMAS NORLIN D.C.

Provider Business Mailing Address
First Line	:	4401 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2339
Country	:	US
Telephone Number	:	612-724-4647
Fax Number	:	612-729-3606

Provider Business Practice Location Address
First Line	:	4401 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2339
Country	:	US
Telephone Number	:	612-724-4647
Fax Number	:	612-729-3606

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	02/12/2015

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