Provider Demographics
NPI:1023149655
Name:HOWE, BRENDEN JERON (DC)
Entity type:Individual
Prefix:DR
First Name:BRENDEN
Middle Name:JERON
Last Name:HOWE
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 1:1050 31ST AVE SW STE A
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-2005
Mailing Address - Country:US
Mailing Address - Phone:701-852-5017
Mailing Address - Fax:701-838-4411
Practice Address - Street 1:1050 31ST AVE SW STE A
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-2005
Practice Address - Country:US
Practice Address - Phone:701-852-5017
Practice Address - Fax:701-838-4411
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND23111OtherMEDICARE ID#
ND13373Medicaid
ND13373Medicaid
ND23111Medicare PIN
ND23111OtherMEDICARE ID#