Provider Demographics
NPI:1841417201
Name:MESSER, DELRAE (DC)
Entity Type:Individual
Prefix:
First Name:DELRAE
Middle Name:
Last Name:MESSER
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 1:16372 KENRICK AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-3543
Mailing Address - Country:US
Mailing Address - Phone:952-435-7017
Mailing Address - Fax:952-435-7062
Practice Address - Street 1:16372 KENRICK AVE STE 210
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-3543
Practice Address - Country:US
Practice Address - Phone:952-435-7017
Practice Address - Fax:952-435-7062
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor