Provider Demographics
NPI:1144741620
Name:REISNOUR, BRITTNEY (DC)
Entity Type:Individual
Prefix:DR
First Name:BRITTNEY
Middle Name:
Last Name:REISNOUR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 MAIN ST NW STE 330
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-8407
Mailing Address - Country:US
Mailing Address - Phone:763-280-7720
Mailing Address - Fax:
Practice Address - Street 1:3200 MAIN ST NW STE 330
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55448-8407
Practice Address - Country:US
Practice Address - Phone:763-280-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6216111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation