Provider Demographics
NPI:1326408568
Name:ADVANCED CARE CHIROPRCTIC
Entity Type:Organization
Organization Name:ADVANCED CARE CHIROPRCTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIRORACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:
Authorized Official - Last Name:OSVOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-893-8900
Mailing Address - Street 1:14001 RIDGEDALE DR STE 390
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1751
Mailing Address - Country:US
Mailing Address - Phone:952-893-8900
Mailing Address - Fax:952-893-7399
Practice Address - Street 1:14001 RIDGEDALE DR STE 390
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1751
Practice Address - Country:US
Practice Address - Phone:952-893-8900
Practice Address - Fax:952-893-7399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6194111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty