Provider Demographics
NPI:1053376459
Name:DOLEZAL, BARBARA L (DC)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:L
Last Name:DOLEZAL
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 1:510 22ND AVE E
Mailing Address - Street 2:SUITE 701
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-4653
Mailing Address - Country:US
Mailing Address - Phone:320-763-9711
Mailing Address - Fax:320-763-9707
Practice Address - Street 1:510 22ND AVE E
Practice Address - Street 2:SUITE 701
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-4653
Practice Address - Country:US
Practice Address - Phone:320-763-9711
Practice Address - Fax:320-763-9707
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor