Individual
DR. RUSSELL S DERHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4630 97TH AVE N, BROOKLYN PARK, MN 55443-4027
(763) 486-3945
(763) 425-2417
Mailing address
4630 97TH AVE N, BROOKLYN PARK, MN 55443-4027
(763) 486-3945
(763) 425-2417
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4717
MN
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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