Provider Demographics
NPI:1811057268
Name:SCHANK, BRENT SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:SCOTT
Last Name:SCHANK
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 1:111 SECOND ST. N
Mailing Address - Street 2:P.O. BOX 279
Mailing Address - City:WINSTED
Mailing Address - State:MN
Mailing Address - Zip Code:55395
Mailing Address - Country:US
Mailing Address - Phone:320-485-3700
Mailing Address - Fax:
Practice Address - Street 1:111 SECOND ST. N
Practice Address - Street 2:
Practice Address - City:WINSTED
Practice Address - State:MN
Practice Address - Zip Code:55395
Practice Address - Country:US
Practice Address - Phone:320-485-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111NRO400X111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU55830Medicare UPIN