Tara Carlson, D.C,
Individual provider Active NPI Pediatric Chiropractor · Wayzata, MN
NPI 1669866968 · NPPES record last updated Mar 24, 2015
Key facts
- NPI
- 1669866968
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Chiropractor 111NP0017X
- License
- 6055 (MN)
- Practice address
- 700 Twelve Oaks Center Dr
Suite 734
Wayzata, MN 55391-4401 - Phone
- (952) 215-9411
- NPI assigned
- Mar 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6055 | MN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Chiropractor | 111NP0017X | 6055 | MN | Yes |
Addresses
Primary practice location
700 Twelve Oaks Center Dr
Suite 734
Wayzata, MN 55391-4401
Mailing address
572 Harrington Rd
Wayzata, MN 55391-1550
Phone (952) 215-9411
Other providers in Wayzata, MN
- Lori R Cao
- Carelink, Inc.
- Caretap Ut
- Brooke Carlson
- Jolene Margaret Carlson
- Katherine Ann Carosella
- Christa Marie Carpenter
- Julia May Carpenter
- Kara Carper
- Robert Collins Cavender Jr.
All providers in Wayzata, MN · Pediatric Chiropractor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.