Provider Demographics
NPI:1821379637
Name:DURTSCHE, MINDY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MINDY
Middle Name:ANN
Last Name:DURTSCHE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MINDY
Other - Middle Name:ANN
Other - Last Name:MIHALOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2903 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-3135
Mailing Address - Country:US
Mailing Address - Phone:608-397-6226
Mailing Address - Fax:
Practice Address - Street 1:5352 38TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2132
Practice Address - Country:US
Practice Address - Phone:608-397-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4781-012111N00000X
MN5806111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor