Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. BRADLEY DEAN MACK, LATC
Active Sole ProprietorMR. BRADLEY DEAN MACK, LATC is a Athletic Trainer healthcare provider located in EAGAN, Minnesota. NPI 1588785265 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · EAGAN, MN
Registration Details
- NPI Number
- 1588785265
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 2, 2007 (19.342440060339 yrs)
- Last Updated
- Jul 8, 2007
- License
-
1568 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4185 BRADDOCK TRLEAGAN, MN, 551231575Browse MN providers · Browse ZIP 55123
- Phone
- 6516836945
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in EAGAN, MN
| Name | Credential | NPI |
|---|---|---|
| CHAD J KRAWIEC | ATC | 1841419256 |
| MRS. JENNA LYNN ARNOLD | ATC, ATL | 1073749263 |
| ANNA LYNN CONNELLY | ATC | 1639510845 |
| DERRICK DAVIS | — | 1801203609 |
| NICHOLAS DEPHILLIPO | ST, SA | 1992113534 |
| KARA BETH ROSE | — | 1700268828 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.