Provider Demographics
NPI:1770878761
Name:ANDREA BURCKHARD DC PA
Entity type:Organization
Organization Name:ANDREA BURCKHARD DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BURCKHARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-200-2386
Mailing Address - Street 1:7400 METRO BLVD STE 360
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2362
Mailing Address - Country:US
Mailing Address - Phone:952-920-3215
Mailing Address - Fax:952-920-0728
Practice Address - Street 1:7400 METRO BLVD STE 360
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2362
Practice Address - Country:US
Practice Address - Phone:952-920-3215
Practice Address - Fax:952-920-0728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty