Provider Demographics
NPI:1063132561
Name:BRIARD, LANCE
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:BRIARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 GOLDEN VALLEY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4475
Mailing Address - Country:US
Mailing Address - Phone:763-533-0541
Mailing Address - Fax:612-365-0307
Practice Address - Street 1:8301 GOLDEN VALLEY RD STE 202
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4475
Practice Address - Country:US
Practice Address - Phone:507-227-9685
Practice Address - Fax:612-365-0307
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist