Provider Demographics
NPI:1427134428
Name:JOYCE E. NEUMAN & DEAN S. BRANDT PTRS.
Entity type:Organization
Organization Name:JOYCE E. NEUMAN & DEAN S. BRANDT PTRS.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:SHERMAN
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PEDORTHIST
Authorized Official - Phone:218-568-6690
Mailing Address - Street 1:37584 EGRET RD
Mailing Address - Street 2:
Mailing Address - City:CROSSLAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56442-2786
Mailing Address - Country:US
Mailing Address - Phone:218-568-6690
Mailing Address - Fax:218-568-6792
Practice Address - Street 1:4450 MAIN ST
Practice Address - Street 2:
Practice Address - City:PEQUOT LAKES
Practice Address - State:MN
Practice Address - Zip Code:56472
Practice Address - Country:US
Practice Address - Phone:218-568-6690
Practice Address - Fax:218-568-6792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2008-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN998156000Medicaid
MN998156000Medicaid