Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 6901 | MN |
N | 111NS0005X | Chiropractic Sports Physician | DC36181 | CA |
NPI | 1366108334 |
---|---|
Provider Name | Dr. Angela Mary Erdmann |
First Address | Edina, MN 55435-2367 |
Second Address | Edina, MN 55435-2367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2021 |
Last Update Date | 14/11/2021 |