| Breanna Black, DC | |
|
11349 Highway 7, Minnetonka, MN 55305-5300 | |
| (507) 382-2373 | |
| Not Available |
| Full Name | Breanna Black |
|---|---|
| Gender | Female |
| Speciality | Chiropractor |
| Location | 11349 Highway 7, Minnetonka, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265193213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 6926 (Minnesota) | Primary |
| Provider Name | Advanced Chiropractic Of Mankato Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1265508089 PECOS PAC ID: 5698724409 Enrollment ID: O20050119000711 |
| Mailing Address | Practice Location Address |
|---|---|
| Breanna Black, DC 18829 147th St Nw, Elk River, MN 55330-7639 Ph: (507) 382-2373 | Breanna Black, DC 11349 Highway 7, Minnetonka, MN 55305-5300 Ph: (507) 382-2373 |
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