OrganizationActive
Andrea White
NPI 1104228584 · Massage Therapist · Maple Grove, MN
Provider details
- NPI number
- 1104228584
- Entity type
- Organization
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Parent organization
- Broman Chiropractic Clinic
- Organization subpart
- Yes
- Authorized official
- Mary Howard, Billing Manager(763) 420-8595
- License
- 2014-99 (MN)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
7237 Forestview Ln N
Maple Grove, MN 55369-5501
Phone: (763) 420-8595
Fax: (763) 420-2029
Approximate (ZIP-level) locationGet directions
Mailing address
7237 Forestview Ln N
Maple Grove, MN 55369-5501
Registry dates
- Enumerated
- 2014-09-17
- Last updated
- 2014-09-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.