Provider Demographics
NPI:1154966794
Name:VELIN, TREVOR (DC)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:VELIN
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 1:1611 COUNTY HIGHWAY 10
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55432-2124
Mailing Address - Country:US
Mailing Address - Phone:763-784-1540
Mailing Address - Fax:763-784-3383
Practice Address - Street 1:1611 COUNTY HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:SPRING LAKE PARK
Practice Address - State:MN
Practice Address - Zip Code:55432-2124
Practice Address - Country:US
Practice Address - Phone:763-784-1540
Practice Address - Fax:763-784-3383
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6660OtherMINNESOTA CHIROPRACTIC LICENSE