MEDICARE: DR. JESSICA N. S. KING 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
1	111N00000X	Chiropractor	6548	MN

General Provider Information

NPI Number	:	1407328677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA N. S. KING DC

Provider Business Mailing Address
First Line	:	7600 BRISTOL VILLAGE DR APT 218
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55438-2592
Country	:	US
Telephone Number	:	715-379-7323
Fax Number	:

Provider Business Practice Location Address
First Line	:	7801 E BUSH LAKE RD STE 280
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55439-3144
Country	:	US
Telephone Number	:	952-800-5464
Fax Number	:

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

Provider Enumeration Date	:	12/27/2018
Last Update Date	:	12/27/2018

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