Provider Demographics
NPI:1427148451
Name:BRAUN, MARLIN R (DC)
Entity type:Individual
Prefix:DR
First Name:MARLIN
Middle Name:R
Last Name:BRAUN
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 1:417 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-4312
Mailing Address - Country:US
Mailing Address - Phone:605-664-2700
Mailing Address - Fax:605-260-8819
Practice Address - Street 1:417 WALNUT ST
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-4312
Practice Address - Country:US
Practice Address - Phone:605-664-2700
Practice Address - Fax:605-260-8819
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7600792Medicaid
SDS101269Medicare PIN