Provider Demographics
NPI:1740961739
Name:STUBBS, BRION JUNIOR (CPT)
Entity type:Individual
Prefix:
First Name:BRION
Middle Name:JUNIOR
Last Name:STUBBS
Suffix:
Gender:M
Credentials:CPT
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Other - Credentials:
Mailing Address - Street 1:9975 VALLEY VIEW RD STE F
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3526
Mailing Address - Country:US
Mailing Address - Phone:612-361-1381
Mailing Address - Fax:
Practice Address - Street 1:9975 VALLEY VIEW RD STE F
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3526
Practice Address - Country:US
Practice Address - Phone:612-361-1381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy