Provider Demographics
NPI:1215265335
Name:DALBEC, JACOB BRADLEY (DC)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:BRADLEY
Last Name:DALBEC
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 1:33 HAMLINE AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2231
Mailing Address - Country:US
Mailing Address - Phone:651-690-0866
Mailing Address - Fax:651-690-0031
Practice Address - Street 1:33 HAMLINE AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2231
Practice Address - Country:US
Practice Address - Phone:651-690-0866
Practice Address - Fax:651-690-0031
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5289111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor