Provider Demographics
NPI:1659609154
Name:MICHELLE L. MEINHOLZ, D.C., PLLC
Entity Type:Organization
Organization Name:MICHELLE L. MEINHOLZ, D.C., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MEINHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-430-1775
Mailing Address - Street 1:2920 BRYANT AVE S
Mailing Address - Street 2:SUITE #106
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2195
Mailing Address - Country:US
Mailing Address - Phone:612-554-3570
Mailing Address - Fax:
Practice Address - Street 1:2920 BRYANT AVE S
Practice Address - Street 2:SUITE #106
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2195
Practice Address - Country:US
Practice Address - Phone:612-554-3570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty