Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC3969 | MN |
N | 111NR0400X | Rehabilitation Chiropractor | DC3969 | MN |
NPI | 1013149442 |
---|---|
Provider Name | Dr. Jason Paul Strandberg |
First Address | Minnetonka, MN 55305-1986 |
Second Address | Minnetonka, MN 55305-1986 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2009 |
Last Update Date | 22/01/2019 |