Provider Demographics
NPI:1952499949
Name:ALLIE, DAVID PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:ALLIE
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 1:1654 RICE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-3757
Mailing Address - Country:US
Mailing Address - Phone:651-487-5334
Mailing Address - Fax:651-487-7684
Practice Address - Street 1:1654 RICE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-3757
Practice Address - Country:US
Practice Address - Phone:651-487-5334
Practice Address - Fax:651-487-7684
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2927111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN366828200Medicaid
MN350004223Medicare PIN
MNU29736Medicare UPIN