Provider Demographics
NPI:1659473700
Name:CLAUSSEN, FREDERICK LEWIS (DC)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:LEWIS
Last Name:CLAUSSEN
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 1:733 NEWTON AVE SE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MN
Mailing Address - Zip Code:55388
Mailing Address - Country:US
Mailing Address - Phone:952-955-3005
Mailing Address - Fax:952-955-3005
Practice Address - Street 1:8441 WAYZATA BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1344
Practice Address - Country:US
Practice Address - Phone:952-473-3336
Practice Address - Fax:763-546-8793
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1911111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T65406Medicare UPIN
MN359000469Medicare ID - Type Unspecified