MEDICARE: DR. FREDERICK LEWIS CLAUSSEN 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	1911	MN

General Provider Information

NPI Number	:	1659473700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERICK LEWIS CLAUSSEN DC

Provider Business Mailing Address
First Line	:	733 NEWTON AVE SE
Second Line	:
City	:	WATERTOWN
State	:	MN
Zip	:	55388
Country	:	US
Telephone Number	:	952-955-3005
Fax Number	:	952-955-3005

Provider Business Practice Location Address
First Line	:	8441 WAYZATA BLVD
Second Line	:	SUITE 370
City	:	GOLDEN VALLEY
State	:	MN
Zip	:	55426-1344
Country	:	US
Telephone Number	:	952-473-3336
Fax Number	:	763-546-8793

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	01/11/2010

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