Provider Demographics
NPI:1841388113
Name:HILBERT, BRIAN LEE (DC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:LEE
Last Name:HILBERT
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 1:4142 2ND ST S
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-3704
Mailing Address - Country:US
Mailing Address - Phone:320-255-5188
Mailing Address - Fax:320-255-1969
Practice Address - Street 1:4142 2ND ST S
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-3704
Practice Address - Country:US
Practice Address - Phone:320-255-5188
Practice Address - Fax:320-255-1969
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN002715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC03280Medicare ID - Type UnspecifiedCLINIC
MNU25089Medicare UPIN