Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. LARRY BRACKENBURY
Active Sole ProprietorMR. LARRY BRACKENBURY is a Contractor healthcare provider located in PINE CITY, Minnesota. NPI 1770842700 is currently active in the NPPES registry. Verify at CMS.
Contractor · PINE CITY, MN
Registration Details
- NPI Number
- 1770842700
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 11, 2012 (14.259788515179 yrs)
- Last Updated
- May 11, 2012
- Sole Proprietor
- Yes
Practice Information
- Address
-
810 8TH ST SWPINE CITY, MN, 550632037Browse MN providers · Browse ZIP 55063
- Phone
- 3206293730
- Primary Specialty
-
Contractor
171W00000X
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.