Individual
DR. BARRY WILLIAM BICANICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3404 UNIVERSITY AVE SE # 3406, MINNEAPOLIS, MN 55414-3328
(612) 331-4529
(612) 331-4148
Mailing address
2145 TIMMY ST, SAINT PAUL, MN 55120-1313
(651) 452-2999
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2106
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01448BI
BLUE CROSS PROVIDER #
MN
01
—
29320BI
BLUE CROSS PIN
MN
Enumeration date
09/20/2006
Last updated
07/09/2007
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