Provider Demographics
NPI:1386239242
Name:TRUE POTENTIAL CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:TRUE POTENTIAL CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-291-8830
Mailing Address - Street 1:4900 HIGHWAY 169 N STE 250
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55428-4019
Mailing Address - Country:US
Mailing Address - Phone:763-291-8830
Mailing Address - Fax:
Practice Address - Street 1:4900 HIGHWAY 169 N STE 250
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428-4019
Practice Address - Country:US
Practice Address - Phone:763-291-8830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center