Provider Demographics
NPI:1386734903
Name:BROST, BARBRO (DC)
Entity type:Individual
Prefix:
First Name:BARBRO
Middle Name:
Last Name:BROST
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 1:1421 WAYZATA BLVD E
Mailing Address - Street 2:SUITE 61
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-3356
Mailing Address - Country:US
Mailing Address - Phone:952-473-9637
Mailing Address - Fax:952-473-1851
Practice Address - Street 1:1421 WAYZATA BLVD E
Practice Address - Street 2:SUITE 61
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-3356
Practice Address - Country:US
Practice Address - Phone:952-473-9637
Practice Address - Fax:952-473-1851
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor