Provider Demographics
NPI:1821815275
Name:BRABANDT, PAIGE (DC)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:BRABANDT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 9TH AVE N APT 202
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-2750
Mailing Address - Country:US
Mailing Address - Phone:701-833-4474
Mailing Address - Fax:
Practice Address - Street 1:13352 ABERDEEN ST NE
Practice Address - Street 2:
Practice Address - City:HAM LAKE
Practice Address - State:MN
Practice Address - Zip Code:55304-6877
Practice Address - Country:US
Practice Address - Phone:763-786-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7265111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor