Organization
MINNESOTA SPINE & SPORTS REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY VERNON NORTHRUP D.C. (OWNER/OPERATOR)
(507) 895-2940
Entity
Organization
Contact information
Practice address
29 S WALNUT ST STE 200, LA CRESCENT, MN 55947-1605
(507) 895-2940
Mailing address
29 S WALNUT ST STE 200, LA CRESCENT, MN 55947-1605
(507) 895-2940
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
5324
MN
Other
Enumeration date
05/08/2013
Last updated
05/08/2013
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