Provider Demographics
NPI:1467534651
Name:ALLENBURG, JOHN T (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:ALLENBURG
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 1:4926 42ND AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-1731
Mailing Address - Country:US
Mailing Address - Phone:763-537-3927
Mailing Address - Fax:763-537-1421
Practice Address - Street 1:4926 42ND AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-1731
Practice Address - Country:US
Practice Address - Phone:763-537-3927
Practice Address - Fax:763-537-1421
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1H018ALOtherBCBS MN
MN1H018ALOtherBCBS MN