Individual
MR. BRIAN CARL MALZER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2443 LARPENTEUR AVE W, LAUDERDALE, MN 55113-5200
(651) 917-9800
(651) 917-9801
Mailing address
1824 WALNUT ST, LAUDERDALE, MN 55113-5245
(651) 647-6972
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4449
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540T6MA
IND. BCBS PROVDER #
MN
Enumeration date
04/05/2006
Last updated
07/08/2007
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