Provider Demographics
NPI:1639256217
Name:SCHMITZ, BRIAN ANTHONY (D C)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ANTHONY
Last Name:SCHMITZ
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14245 SAINT FRANCIS BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-4793
Mailing Address - Country:US
Mailing Address - Phone:763-422-1525
Mailing Address - Fax:763-422-3747
Practice Address - Street 1:14245 SAINT FRANCIS BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-4793
Practice Address - Country:US
Practice Address - Phone:763-422-1525
Practice Address - Fax:763-422-3747
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4506111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1416693-00Medicaid
MN350003761Medicare PIN
MN1416693-00Medicaid