Provider Demographics
NPI:1821560509
Name:CARLSON, CHLOE MARIA (DC)
Entity Type:Individual
Prefix:DR
First Name:CHLOE
Middle Name:MARIA
Last Name:CARLSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7492 W 78TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2513
Mailing Address - Country:US
Mailing Address - Phone:952-255-6980
Mailing Address - Fax:952-255-6985
Practice Address - Street 1:7492 W 78TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55439-2513
Practice Address - Country:US
Practice Address - Phone:952-255-6980
Practice Address - Fax:952-255-6985
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor