Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 6906 | MN |
N | 111NS0005X | Chiropractic Sports Physician | 6906 | MN |
NPI | 1104585215 |
---|---|
Provider Name | Dr. Brandyn S Christman |
First Address | Minneapolis, MN 55408-2177 |
Second Address | Minneapolis, MN 55408-2171 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2021 |
Last Update Date | 27/12/2021 |