Mack, Bradley Dean

Mack, Bradley Dean is an sole proprietor health care provider with primary practice located at 4185 Braddock Trl , Eagan MN 55123-1575. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Mack, Bradley Dean can be contacted via phone (651) 683-6945.

Contact Information

Primary practice address
4185 Braddock Trl Eagan MN 55123-1575
Phone: (651) 683-6945
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 1568 Minnesota

Profile Details

NPI number 1588785265
LBN Legal business name Mack, Bradley Dean
Credentials Licensed Athletic Trainer, Certified (LATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 2nd, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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