Provider Demographics
NPI:1407433899
Name:GINDER, CONNOR REED (DC)
Entity Type:Individual
Prefix:DR
First Name:CONNOR
Middle Name:REED
Last Name:GINDER
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 1:5707 HIGHWAY 7 APT 124
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2391
Mailing Address - Country:US
Mailing Address - Phone:541-654-2390
Mailing Address - Fax:
Practice Address - Street 1:4717 CLARK AVE
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-3221
Practice Address - Country:US
Practice Address - Phone:651-762-8040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor