Provider Demographics
NPI:1760693154
Name:BRYANT R. BEEHLER, D.O., LTD.
Entity Type:Organization
Organization Name:BRYANT R. BEEHLER, D.O., LTD.
Other - Org Name:NORTH METRO OSTEOPATHIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYANT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BEEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:701-239-3738
Mailing Address - Street 1:3863 COON RAPIDS BLVD NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2518
Mailing Address - Country:US
Mailing Address - Phone:701-239-3738
Mailing Address - Fax:701-239-3738
Practice Address - Street 1:3863 COON RAPIDS BLVD NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2518
Practice Address - Country:US
Practice Address - Phone:701-239-3738
Practice Address - Fax:701-239-3738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN27285261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation