Individual
BRIAN SCOTT CHANCE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3007 HARBOR LN N STE 1200, PLYMOUTH, MN 55447-5103
(612) 439-4650
Mailing address
13624 74TH AVE N, MAPLE GROVE, MN 55311-2767
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MN
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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