Provider Demographics
NPI:1205258464
Name:JULEEN, KEVIN C (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:C
Last Name:JULEEN
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 1:1000 COUNTY ROAD E W STE 210
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-8096
Mailing Address - Country:US
Mailing Address - Phone:651-766-4600
Mailing Address - Fax:651-766-4603
Practice Address - Street 1:1000 COUNTY ROAD E W STE 210
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-8096
Practice Address - Country:US
Practice Address - Phone:651-766-4600
Practice Address - Fax:651-766-4603
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor