Provider Demographics
NPI:1932145141
Name:HEDMAN, BRIAN LEE (DC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:LEE
Last Name:HEDMAN
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 1:307 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WINDOM
Mailing Address - State:MN
Mailing Address - Zip Code:56101-1658
Mailing Address - Country:US
Mailing Address - Phone:507-831-4770
Mailing Address - Fax:507-831-2077
Practice Address - Street 1:307 9TH ST
Practice Address - Street 2:
Practice Address - City:WINDOM
Practice Address - State:MN
Practice Address - Zip Code:56101-1658
Practice Address - Country:US
Practice Address - Phone:507-831-4770
Practice Address - Fax:507-831-2077
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN003255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN10156OtherCCMI
MN4C695HEOtherBCBS OF MN
MN231970OtherU CARE
MN22049OtherSIOUX VALLEY HEALTH PLAN
MN1016365OtherPREFERRED ONE
MN231970OtherU CARE