Provider Demographics
NPI:1205074051
Name:LONNQUIST, ANDREW DEAN (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DEAN
Last Name:LONNQUIST
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 1:801 TWELVE OAKS CENTER DR
Mailing Address - Street 2:SUITE 811
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-4601
Mailing Address - Country:US
Mailing Address - Phone:952-475-1044
Mailing Address - Fax:
Practice Address - Street 1:801 TWELVE OAKS CENTER DR
Practice Address - Street 2:SUITE 811
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4601
Practice Address - Country:US
Practice Address - Phone:952-475-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3342111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor