Individual
BRADLEY VERNON NORTHRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1053 GRAND AVE, #114, SAINT PAUL, MN 55105-3022
(651) 292-9247
Mailing address
1053 GRAND AVE, #114, SAINT PAUL, MN 55105-3022
(651) 292-9247
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5324
MN
Other
Enumeration date
10/07/2009
Last updated
04/26/2010
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