Individual
MARIE L BREKKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 280-4375
(701) 461-5764
Mailing address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 280-4375
(701) 461-5764
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
PAC0143
ND
363A00000X
Physician Assistant
Primary
PAC0143
ND
Other
Enumeration date
07/16/2006
Last updated
09/27/2018
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