Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3958 | MN |
N | 111NN1001X | Nutrition | 3958 | MN |
NPI | 1366529554 |
---|---|
Provider Name | Dr. Linda J. Dobberstein |
First Address | Bloomington, MN 55431-2928 |
Second Address | Bloomington, MN 55420-2754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 01/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V02444 | (02) | MN |