Provider Demographics
NPI:1255532909
Name:BRANES, JOEL KEITH (DC)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:KEITH
Last Name:BRANES
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 1:9220 ARCHER LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-1811
Mailing Address - Country:US
Mailing Address - Phone:763-494-5501
Mailing Address - Fax:
Practice Address - Street 1:13700 83RD WAY N STE 200
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-7015
Practice Address - Country:US
Practice Address - Phone:763-420-4242
Practice Address - Fax:763-494-0782
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor