Provider Demographics
NPI:1568696672
Name:JOHN C. BRETT, P.A.
Entity Type:Organization
Organization Name:JOHN C. BRETT, P.A.
Other - Org Name:BRETT CHIROPRACTIC & ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-897-0324
Mailing Address - Street 1:200 W 98TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-3820
Mailing Address - Country:US
Mailing Address - Phone:952-897-0324
Mailing Address - Fax:952-897-9051
Practice Address - Street 1:200 W 98TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-3820
Practice Address - Country:US
Practice Address - Phone:952-897-0324
Practice Address - Fax:952-897-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty