MEDICARE: DR. CYNTHIA LYNN OPP 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	111N00000X	Chiropractor	4400	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	132R9OP	OTHER	MN	BCBS
2	744450800	OTHER	MN	MHCP

General Provider Information

NPI Number	:	1548256787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA LYNN OPP D.C.

Provider Business Mailing Address
First Line	:	4111 232ND AVE NW
Second Line	:
City	:	ST FRANCIS
State	:	MN
Zip	:	55070-8778
Country	:	US
Telephone Number	:	763-753-7339
Fax Number	:

Provider Business Practice Location Address
First Line	:	23168 SAINT FRANCIS BLVD NW
Second Line	:	SUITE 600
City	:	ST FRANCIS
State	:	MN
Zip	:	55070-9805
Country	:	US
Telephone Number	:	763-213-0615
Fax Number	:	763-213-0616

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	07/08/2007

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