Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 4417 | MN |
NPI | 1083738512 |
---|---|
Provider Name | Dr. Hal A. Brown |
First Address | Apple Valley, MN 55124-5757 |
Second Address | Apple Valley, MN 55124-5757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |