Provider Demographics
NPI:1972874469
Name:TEVLIN, LINDSEY MARIE (DC)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:MARIE
Last Name:TEVLIN
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 1:333 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2582
Mailing Address - Country:US
Mailing Address - Phone:218-348-2800
Mailing Address - Fax:651-294-2333
Practice Address - Street 1:6445 LAKE ROAD TER STE 302
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1495
Practice Address - Country:US
Practice Address - Phone:651-294-2332
Practice Address - Fax:651-294-2333
Is Sole Proprietor?:No
Enumeration Date:2012-01-16
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor