Provider Demographics
NPI:1881355972
Name:BROWN, DANIEL J (DC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:BROWN
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 1:12919 OLIVER AVE S
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2091
Mailing Address - Country:US
Mailing Address - Phone:952-388-9061
Mailing Address - Fax:
Practice Address - Street 1:3570 LEXINGTON AVE N STE 208
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-8058
Practice Address - Country:US
Practice Address - Phone:651-400-7026
Practice Address - Fax:651-481-8051
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-01
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6927111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports Physician