Provider Demographics
NPI:1780731836
Name:LAMPPA, MICHAEL RAYMOND (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RAYMOND
Last Name:LAMPPA
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 1:6600 FRANCE AVE S STE 206
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1810
Mailing Address - Country:US
Mailing Address - Phone:952-926-7515
Mailing Address - Fax:
Practice Address - Street 1:6600 FRANCE AVE S STE 206
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-1810
Practice Address - Country:US
Practice Address - Phone:952-926-7515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1658111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN933727000Medicaid
MN350003536Medicare ID - Type Unspecified
MN51214LAMedicare UPIN