Provider Demographics
NPI:1477857522
Name:SMAAGAARD, LORRAINE SARAH (DC)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:SARAH
Last Name:SMAAGAARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:LORRAINE
Other - Middle Name:SARAH
Other - Last Name:HURST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8160 COLLER WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3600
Mailing Address - Country:US
Mailing Address - Phone:612-293-9294
Mailing Address - Fax:
Practice Address - Street 1:2110 EAGLE CREEK LN STE 400
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-3209
Practice Address - Country:US
Practice Address - Phone:612-293-9294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350-002-350Medicare UPIN