Healthcare Provider Details

I. General information

NPI: 1629019195
Provider Name (Legal Business Name): BRIAN SCOTT GARRITY DC, RVT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 LIVINGSTON AVE STE 107
WEST ST PAUL MN
55118-3421
US

IV. Provider business mailing address

1551 LIVINGSTON AVE STE 107
WEST ST PAUL MN
55118-3421
US

V. Phone/Fax

Practice location:
  • Phone: 612-314-5929
  • Fax:
Mailing address:
  • Phone: 612-314-5929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number871
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number196755
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4719
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: