Provider Demographics
NPI:1861699852
Name:ARBOUR, JOAN ROSALIE (DC)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:ROSALIE
Last Name:ARBOUR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8636 SUMMER WIND ALCOVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4806
Mailing Address - Country:US
Mailing Address - Phone:651-702-1265
Mailing Address - Fax:
Practice Address - Street 1:2353 RICE ST
Practice Address - Street 2:SUITE 210
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3739
Practice Address - Country:US
Practice Address - Phone:651-203-0040
Practice Address - Fax:651-486-7594
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3362111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor