Provider Demographics
NPI:1669264016
Name:VONDRAK, BRANDON
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:VONDRAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4917 S GRAYSTONE AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8566
Mailing Address - Country:US
Mailing Address - Phone:712-577-1585
Mailing Address - Fax:
Practice Address - Street 1:5128 S CLIFF AVE STE 200
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5454
Practice Address - Country:US
Practice Address - Phone:605-357-8093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1513111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor