Provider Demographics
NPI:1134423023
Name:LABER, BROOKS CYRIL (DC)
Entity type:Individual
Prefix:DR
First Name:BROOKS
Middle Name:CYRIL
Last Name:LABER
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 1:1100 4TH AVE E
Mailing Address - Street 2:STE 220
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-1689
Mailing Address - Country:US
Mailing Address - Phone:952-456-6611
Mailing Address - Fax:
Practice Address - Street 1:1100 4TH AVE E
Practice Address - Street 2:STE 220
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-1689
Practice Address - Country:US
Practice Address - Phone:952-456-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5462111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor