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Individual

MR. BRIAN BANTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.AC

Contact information

Practice address
1224 2ND ST NE, MINNEAPOLIS, MN 55413-1130
(612) 399-6322
Mailing address
1224 2ND ST NE, MINNEAPOLIS, MN 55413-1130

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1756
MN

Other

Enumeration date
05/22/2020
Last updated
05/22/2020
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