Individual
MR. NATHAN LEE BRESKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4995013
BLUE CROSS
SD
05
—
5834740
—
SD
Enumeration date
06/21/2005
Last updated
01/10/2008
Update your record
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