Brackenbury, Larry

Brackenbury, Larry is an sole proprietor health care provider with primary practice located at 810 8Th St Sw , Pine City MN 55063-2037. He recently has only one registered license in Other Service Providers / Contractor, which is considered as his primary health care specialty. Brackenbury, Larry can be contacted via phone (320) 629-3730.

Contact Information

Primary practice address
810 8Th St Sw Pine City MN 55063-2037
Phone: (320) 629-3730
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X

Profile Details

NPI number 1770842700
LBN Legal business name Brackenbury, Larry
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2012
Last updated May 11th, 2012 - about 14 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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