Provider Demographics
NPI:1336312339
Name:TOMLINSON, JOHN MICHAEL LEO (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL LEO
Last Name:TOMLINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4770 CENTERVILLE RD
Mailing Address - Street 2:304
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55127-2335
Mailing Address - Country:US
Mailing Address - Phone:651-226-4191
Mailing Address - Fax:
Practice Address - Street 1:3495 WILLOW LAKE BLVD
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-5138
Practice Address - Country:US
Practice Address - Phone:651-226-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5114111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor