Provider Demographics
NPI:1902086143
Name:MAXIMUM LIFE, INC.
Entity Type:Organization
Organization Name:MAXIMUM LIFE, INC.
Other - Org Name:MAXIMUM LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:WENDELL
Authorized Official - Last Name:BJORKLUND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-315-1282
Mailing Address - Street 1:12486 74TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-5285
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8509 JEFFERSON LN N
Practice Address - Street 2:SUITE 110
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2119
Practice Address - Country:US
Practice Address - Phone:763-311-5128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty