Bradley Scott Horoshak, DC
Individual provider Active NPI Chiropractor · Cook, MN
NPI 1497930861 · NPPES record last updated Jan 4, 2008
Key facts
- NPI
- 1497930861
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3729 (MN)
- Practice address
- 19 E Vermilion Dr
PO 395
Cook, MN 55723 - Phone
- (218) 666-5104
- NPI assigned
- Jan 4, 2008
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3729 | MN | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3729 | MN | Yes |
Addresses
Primary practice location
19 E Vermilion Dr
PO 395
Cook, MN 55723
Mailing address
19 E Vermilion Dr
PO 395
Cook, MN 55723
Phone (218) 666-5104
Other providers in Cook, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.