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1477183192
BRYAN GEORGE DEMAINE
SAINT CLOUD, MN
NPI
1477183192
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MN 1576)
Enumeration Date
2020-01-22
Last Update Date
2020-01-22
Business Address
Mr. BRYAN GEORGE DEMAINE ATC
720 4TH AVE S # 133
SAINT CLOUD, MN 56301-4498
Phone number: 320-308-2588
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Mailing Address
Mr. BRYAN GEORGE DEMAINE ATC
3087 OLYMPUS DR NE
SAUK RAPIDS, MN 56379-4411
Phone number: 320-247-3330
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