Provider Demographics
NPI:1366477069
Name:HEDLUND, BRYAN JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:JAMES
Last Name:HEDLUND
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:17025 COMMERCIAL PARK DR UNIT 8
Mailing Address - Street 2:SUITE #8
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-6254
Mailing Address - Country:US
Mailing Address - Phone:218-824-3737
Mailing Address - Fax:218-824-3738
Practice Address - Street 1:17025 COMMERCIAL PARK DR
Practice Address - Street 2:SUITE #8
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-6253
Practice Address - Country:US
Practice Address - Phone:218-824-3737
Practice Address - Fax:218-824-3738
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN4785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor