Provider Demographics
NPI:1891268405
Name:HAUER, BRAD (DC)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:
Last Name:HAUER
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 1:5676 LA CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55301-4022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1309 OAK AVE
Practice Address - Street 2:STE 207
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1080
Practice Address - Country:US
Practice Address - Phone:952-442-5557
Practice Address - Fax:612-329-0024
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor