Provider Demographics
NPI:1467998955
Name:SUNDIN, ALEXANDER ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:ROBERT
Last Name:SUNDIN
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 1:800 PRAIRIE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7306
Mailing Address - Country:US
Mailing Address - Phone:952-943-1188
Mailing Address - Fax:952-943-1177
Practice Address - Street 1:800 PRAIRIE CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7306
Practice Address - Country:US
Practice Address - Phone:952-943-1188
Practice Address - Fax:952-943-1177
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60713471111N00000X
MN6541111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor