Provider Demographics
NPI:1801549589
Name:HILL, BRYCE JAMES (DC)
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:JAMES
Last Name:HILL
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 1:1012 DIFFLEY RD STE 600
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-1780
Mailing Address - Country:US
Mailing Address - Phone:877-442-4476
Mailing Address - Fax:
Practice Address - Street 1:1012 DIFFLEY RD STE 600
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-1780
Practice Address - Country:US
Practice Address - Phone:877-442-4476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6964111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor