Provider Demographics
NPI:1467797274
Name:ECKDAHL, MEGAN E (DC)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:E
Last Name:ECKDAHL
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 1:7424 E POINT DOUGLAS RD S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-3025
Mailing Address - Country:US
Mailing Address - Phone:651-458-5565
Mailing Address - Fax:651-458-5023
Practice Address - Street 1:7424 E POINT DOUGLAS RD S
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-3025
Practice Address - Country:US
Practice Address - Phone:651-458-5565
Practice Address - Fax:651-458-5023
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor