Provider Demographics
NPI:1265637979
Name:MOLSKNESS, BRADLEY J (DC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:J
Last Name:MOLSKNESS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7294 147TH LN NW
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-5720
Mailing Address - Country:US
Mailing Address - Phone:763-706-7277
Mailing Address - Fax:
Practice Address - Street 1:18142 MINNETONKA BLVD
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-3327
Practice Address - Country:US
Practice Address - Phone:952-345-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3982111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor