Provider Demographics
NPI:1508385709
Name:MCDOUGLE, CELIA MARIE (DC)
Entity Type:Individual
Prefix:
First Name:CELIA
Middle Name:MARIE
Last Name:MCDOUGLE
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 1:8509 JEFFERSON LN N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2119
Mailing Address - Country:US
Mailing Address - Phone:763-425-4577
Mailing Address - Fax:
Practice Address - Street 1:8509 JEFFERSON LN N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2119
Practice Address - Country:US
Practice Address - Phone:763-425-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6383111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor