Provider Demographics
NPI:1205035524
Name:HEAD TO TOE CHIROPRACTIC CLINIC, PLLC
Entity Type:Organization
Organization Name:HEAD TO TOE CHIROPRACTIC CLINIC, PLLC
Other - Org Name:LINDA J. DOBBERSTEIN, DC, DACBN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOBBERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACBN
Authorized Official - Phone:612-616-5452
Mailing Address - Street 1:9940 PENN AVE S APT 5
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-2928
Mailing Address - Country:US
Mailing Address - Phone:612-616-5452
Mailing Address - Fax:
Practice Address - Street 1:224 W FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2331
Practice Address - Country:US
Practice Address - Phone:612-616-5452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3958111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNV02444Medicare UPIN