Provider Demographics
NPI:1679994909
Name:MAHLER, LUC DIDIER (DC)
Entity Type:Individual
Prefix:
First Name:LUC
Middle Name:DIDIER
Last Name:MAHLER
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 1:14001 RIDGEDALE DR STE 390
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1751
Mailing Address - Country:US
Mailing Address - Phone:952-893-8900
Mailing Address - Fax:952-893-7399
Practice Address - Street 1:14001 RIDGEDALE DR STE 390
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1751
Practice Address - Country:US
Practice Address - Phone:952-893-8900
Practice Address - Fax:952-893-7399
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5878111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor