Provider Demographics
NPI:1437432416
Name:AAMODT, NATALIE JO (DC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:JO
Last Name:AAMODT
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 1:8409 S POND TRL
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-3779
Mailing Address - Country:US
Mailing Address - Phone:952-454-0346
Mailing Address - Fax:
Practice Address - Street 1:1611 COUNTY HIGHWAY 10
Practice Address - Street 2:SPRING LAKE PARK
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55432-2124
Practice Address - Country:US
Practice Address - Phone:763-784-1540
Practice Address - Fax:763-784-3383
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor