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Individual

DR. ANTHONY FAVRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
976 GRAND AVE, SAINT PAUL, MN 55105-3014
(608) 792-3396
Mailing address
976 GRAND AVE, SAINT PAUL, MN 55105-3014
(608) 792-3396

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6683
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6683
STATE LICENSE
MN
Enumeration date
12/31/2019
Last updated
12/31/2019
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