Provider Demographics
NPI:1720841430
Name:ARELLANES, MACKENZIE (DC)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:ARELLANES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:
Other - Last Name:YOUNGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1873 BELMONT AVE NW
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-7805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3939 W 69TH ST UNIT B
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2001
Practice Address - Country:US
Practice Address - Phone:952-562-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor