Provider Demographics
NPI:1356389969
Name:EKELIN, KARYN LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:KARYN
Middle Name:LYNN
Last Name:EKELIN
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 1:7265 JORDON AVE S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-3655
Mailing Address - Country:US
Mailing Address - Phone:651-459-7078
Mailing Address - Fax:
Practice Address - Street 1:1380 N ACRES RD
Practice Address - Street 2:SUITE A
Practice Address - City:PRESCOTT
Practice Address - State:WI
Practice Address - Zip Code:54021-7061
Practice Address - Country:US
Practice Address - Phone:715-262-8555
Practice Address - Fax:715-868-8744
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4760111N00000X
WI4721-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor