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1457812307
BRETT DAVID LACKIE
CHANHASSEN, MN
NPI
1457812307
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MN 11403)
Enumeration Date
2019-03-25
Last Update Date
2019-03-25
Business Address
BRETT DAVID LACKIE DPT
300 LAKE DR E
CHANHASSEN, MN 55317-9302
Phone number: 952-993-4300
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Mailing Address
BRETT DAVID LACKIE DPT
10707 DIRECT RIVER DR NW
COON RAPIDS, MN 55433-3922
Phone number: 612-385-4956
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