Provider Demographics
NPI:1487646089
Name:CAZER, BRANDON STUART (DC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:STUART
Last Name:CAZER
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 1:501 W HAVENS ST
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-4334
Mailing Address - Country:US
Mailing Address - Phone:605-996-1078
Mailing Address - Fax:605-996-3703
Practice Address - Street 1:501 W HAVENS ST
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-4334
Practice Address - Country:US
Practice Address - Phone:605-996-1078
Practice Address - Fax:605-996-3703
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor