Ecklund, Roderick Dale

Ecklund, Roderick Dale is an individual health care provider with primary practice located at 5810 Nicollet Avenue , Minneapolis MN 55419. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Ecklund, Roderick Dale can be contacted via phone (612) 861-2121.

Contact Information

Primary practice address
5810 Nicollet Avenue Minneapolis MN 55419
Phone: (612) 861-2121
Fax: (612) 861-2113
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 002651 Minnesota

Profile Details

NPI number 1831253053
LBN Legal business name Ecklund, Roderick Dale
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2006
Last updated Nov 14th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831253053 NPPES
Minnesota MEDICAID 863328200

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