Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5778 | MN |
NPI | 1003157413 |
---|---|
Provider Name | Dr. Nicholas Elias Eyvindsson |
First Address | Richfield, MN 55423-3550 |
Second Address | Richfield, MN 55423-3550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2013 |
Last Update Date | 11/03/2013 |