Provider Demographics
NPI:1437227089
Name:PASSIG, DANA JON (DC)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:JON
Last Name:PASSIG
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 1:5811 CEDAR LAKE RD S
Mailing Address - Street 2:SUITE E
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1458
Mailing Address - Country:US
Mailing Address - Phone:952-593-0296
Mailing Address - Fax:
Practice Address - Street 1:5811 CEDAR LAKE RD S
Practice Address - Street 2:SUITE E
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1458
Practice Address - Country:US
Practice Address - Phone:952-593-0296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1365111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3D120PAOtherBCBS