Provider Demographics
NPI:1437177250
Name:SATERDALEN, ALYSSA JOY (DC)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:JOY
Last Name:SATERDALEN
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 1:1660 HIGHWAY 100 S STE 500
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1551
Mailing Address - Country:US
Mailing Address - Phone:952-697-4044
Mailing Address - Fax:
Practice Address - Street 1:1660 HIGHWAY 100 S STE 500
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1551
Practice Address - Country:US
Practice Address - Phone:952-697-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4546111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN665914OtherACN PROVIDER
MN530008000Medicaid
MN979T8GOOtherBCBS PROVIDER #
MN350003681Medicare PIN