Organization
INTEGRATED CHIROPRACTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT DAVID VENABLES DC (PARTNER)
(651) 287-8780
Entity
Organization
Contact information
Practice address
4422 WHITE BEAR AVE N, WHITE BEAR LAKE, MN 55110-3475
(651) 287-8780
(651) 287-8786
Mailing address
4422 WHITE BEAR AVE N, WHITE BEAR LAKE, MN 55110-3475
(651) 287-8780
(651) 287-8786
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3592
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
822520600
—
MN
Enumeration date
03/21/2011
Last updated
03/21/2011
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