Healthcare Provider Details

I. General information

NPI: 1235166992
Provider Name (Legal Business Name): BRYANT RICHARD BEEHLER D.O.,F.P.,NMM-OMM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14133 ORCHID ST NW
ANDOVER MN
55304-3283
US

IV. Provider business mailing address

14133 ORCHID ST NW
ANDOVER MN
55304-3283
US

V. Phone/Fax

Practice location:
  • Phone: 763-421-6546
  • Fax: 763-421-6546
Mailing address:
  • Phone: 763-421-6546
  • Fax: 763-421-6546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number27285
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number27285
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: