Provider Demographics
NPI:1487775987
Name:BEHNAM, KAYVON (DC)
Entity type:Individual
Prefix:DR
First Name:KAYVON
Middle Name:
Last Name:BEHNAM
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 1:104 BURNSIDE AVE S
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-1928
Mailing Address - Country:US
Mailing Address - Phone:651-267-0394
Mailing Address - Fax:
Practice Address - Street 1:104 BURNSIDE AVE S
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-1928
Practice Address - Country:US
Practice Address - Phone:651-267-0394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor