Provider Demographics
NPI:1801221411
Name:B.P. SPINE CENTER, P.A.
Entity Type:Organization
Organization Name:B.P. SPINE CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-432-5073
Mailing Address - Street 1:3330 BROOKDALE DR N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-2863
Mailing Address - Country:US
Mailing Address - Phone:763-432-5073
Mailing Address - Fax:763-432-5074
Practice Address - Street 1:3330 BROOKDALE DR N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-2863
Practice Address - Country:US
Practice Address - Phone:763-432-5073
Practice Address - Fax:763-432-5074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty