Provider Demographics
NPI:1598035859
Name:POLICANO, LINDSAY MIKAELLE (DC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MIKAELLE
Last Name:POLICANO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:MIKAELLE
Other - Last Name:ANDRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-9696
Mailing Address - Fax:
Practice Address - Street 1:701 4TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1600
Practice Address - Country:US
Practice Address - Phone:612-873-9696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350004949Medicare PIN