Provider Demographics
NPI:1063142180
Name:BRASKET, DANIEL MARTIN (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MARTIN
Last Name:BRASKET
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 1:4179 RUNNING BROOK RD
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1943
Mailing Address - Country:US
Mailing Address - Phone:952-270-6536
Mailing Address - Fax:
Practice Address - Street 1:860 BLUE GENTIAN ROAD
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2642
Practice Address - Country:US
Practice Address - Phone:952-270-6535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6997111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor