Provider Demographics
NPI:1720544034
Name:DAHLGREN, PARKER (DC)
Entity Type:Individual
Prefix:DR
First Name:PARKER
Middle Name:
Last Name:DAHLGREN
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 1:145 BEAUMONT CT
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-5008
Mailing Address - Country:US
Mailing Address - Phone:952-232-6595
Mailing Address - Fax:
Practice Address - Street 1:145 BEAUMONT CT
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-5008
Practice Address - Country:US
Practice Address - Phone:952-232-6595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor