Provider Demographics
NPI:1265394183
Name:MROZEK, EDEN (DC)
Entity type:Individual
Prefix:DR
First Name:EDEN
Middle Name:
Last Name:MROZEK
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 1:2405 E COUNTRY CLUB CIR APT 204
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:SD
Mailing Address - Zip Code:57005-6760
Mailing Address - Country:US
Mailing Address - Phone:507-363-3925
Mailing Address - Fax:
Practice Address - Street 1:220 E HOLLY BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:SD
Practice Address - Zip Code:57005-1171
Practice Address - Country:US
Practice Address - Phone:605-582-3944
Practice Address - Fax:605-582-3698
Is Sole Proprietor?:No
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor