Provider Demographics
NPI:1376689687
Name:NORLIN, WILLIAM THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:NORLIN
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 1:4401 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2339
Mailing Address - Country:US
Mailing Address - Phone:612-724-4647
Mailing Address - Fax:612-729-3606
Practice Address - Street 1:4401 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2339
Practice Address - Country:US
Practice Address - Phone:612-724-4647
Practice Address - Fax:612-729-3606
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN001817-3111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN12644NOOtherBLUECROSSBLUESHIELD OF MN
MN4480261OtherMEDICA
MN713827000Medicaid
MN350002262Medicare PIN