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General NPI Number Information
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NPI Number | 1447901996
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Entity Type | Organization
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Legal Business Name | VECTOR SPORT AND SPINE : CHIRO & REHAB PLLC
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Dates
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Enumeration Date | 01/17/2022
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 12919 OLIVER AVE S
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City | BURNSVILLE
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State | MN
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Zip | 55337-2091
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Country | US
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Telephone | 952-222-5770
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Fax |
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Provider Business Mailing Address
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Address Line | 12919 OLIVER AVE S
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City | BURNSVILLE
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State | MN
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Zip | 55337-2091
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Country | US
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Telephone | 952-222-5770
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Fax |
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Authorized Official
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Title or Position | SPORTS CHIROPRACTOR
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Name | DR. DANIEL JOSEPH BROWN
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Credential | DC, MS EMT
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Telephone | 952-222-5770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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