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Individual
DR. BRENDA KAREN FORTIN
Active
Individual
DR. BRENDA KAREN FORTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4147
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08154FO
BCBS GROUP/CLINIC
MN
01
—
081G5FO
BCBS INDIVIDUAL
MN
05
—
115092800
—
MN
Enumeration date
08/16/2006
Last updated
08/03/2014
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