Provider Demographics
NPI:1235219767
Name:CIOLA, JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:
Last Name:CIOLA
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 1:3311 COUNTY RD 101 SUITE 2
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-2866
Mailing Address - Country:US
Mailing Address - Phone:952-405-6263
Mailing Address - Fax:952-406-8060
Practice Address - Street 1:3311 COUNTY ROAD 101
Practice Address - Street 2:SUITE 2
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55391
Practice Address - Country:US
Practice Address - Phone:952-405-6263
Practice Address - Fax:952-406-8060
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN345422300Medicaid
MN919S6CIOtherBCBS PROVIDER ID
MN350003203Medicare ID - Type Unspecified
MN345422300Medicaid