Individual
BRAD J MONTAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
501 NORTH ARROWHEAD LN, MOOSE LAKE, MN 55767-0649
(218) 485-4451
Mailing address
PO BOX 649, MOOSE LAKE, MN 55767-0649
(218) 485-4451
(218) 485-4451
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2623
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60715HE
BCBS
MN
05
—
NATIONAL PROVIDER NU
—
MN
Enumeration date
08/18/2006
Last updated
07/21/2022
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