Provider Demographics
NPI:1982775334
Name:SPRATT, TODD J (DC)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:J
Last Name:SPRATT
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 1:5116 GATEWAY ST SE
Mailing Address - Street 2:#202
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-2074
Mailing Address - Country:US
Mailing Address - Phone:952-440-2225
Mailing Address - Fax:952-440-2255
Practice Address - Street 1:5116 GATEWAY ST SE
Practice Address - Street 2:#202
Practice Address - City:PRIOR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55372-2074
Practice Address - Country:US
Practice Address - Phone:952-440-2225
Practice Address - Fax:952-440-2255
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN3533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN059321400Medicaid
MN350001780Medicare PIN