Provider Demographics
NPI:1013149442
Name:STRANDBERG, JASON PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:PAUL
Last Name:STRANDBERG
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 1:14604 WOODHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-2362
Mailing Address - Country:US
Mailing Address - Phone:952-222-7886
Mailing Address - Fax:612-235-7918
Practice Address - Street 1:1700 PLYMOUTH RD APT 417
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1986
Practice Address - Country:US
Practice Address - Phone:612-306-5691
Practice Address - Fax:612-235-7918
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNDC3969111N00000X, 111NR0400X, 111NX0100X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0100XChiropractic ProvidersChiropractorOccupational Health