Provider Demographics
NPI:1467966911
Name:MILBRANDT, COREY STEVEN (DC)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:STEVEN
Last Name:MILBRANDT
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 1:925 E SUPERIOR ST STE 112
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2253
Mailing Address - Country:US
Mailing Address - Phone:218-628-0646
Mailing Address - Fax:218-628-1889
Practice Address - Street 1:925 E SUPERIOR ST STE 112
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2253
Practice Address - Country:US
Practice Address - Phone:218-628-0646
Practice Address - Fax:218-628-1889
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6418111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6418OtherCHIROPRACTIC LICENSE