Theisen, Jo G
Theisen, Jo G is an individual health care provider with primary practice located at 8465 W Broadway Ave , Brooklyn Park MN 55445-2266. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Theisen, Jo G can be contacted via phone (763) 424-7750.Contact Information
Primary practice address
8465 W Broadway Ave
Brooklyn Park MN 55445-2266
Phone: (763) 424-7750
Fax: (763) 424-3444
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 2599 | Minnesota |
Profile Details
| NPI number | 1730262494 |
|---|---|
| LBN Legal business name | Theisen, Jo G |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | Jan 11th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730262494 | NPPES |
| Minnesota | MEDICAID | 416728700 | |
| Minnesota | Other | 1952484602 |
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