Individual
BRIAN LAWRENCE DETHLEFSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
14 N 5TH ST, OAKES, ND 58474-1209
(701) 742-2750
(701) 742-2909
Mailing address
14 N 5TH ST, OAKES, ND 58474-1209
(701) 742-2750
(701) 742-2909
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
637
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10200
—
ND
Enumeration date
09/20/2006
Last updated
09/16/2013
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