Provider Demographics
NPI:1033230214
Name:COTTRELL, CLAUDIA CARLSON (DC)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:CARLSON
Last Name:COTTRELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 W SUPERIOR STREET
Mailing Address - Street 2:STE. 501
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2063
Mailing Address - Country:US
Mailing Address - Phone:218-740-3379
Mailing Address - Fax:218-740-3380
Practice Address - Street 1:31 W SUPERIOR ST
Practice Address - Street 2:STE. 501
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2063
Practice Address - Country:US
Practice Address - Phone:218-740-3379
Practice Address - Fax:218-740-3380
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN86DO3CIMedicare UPIN