Individual
KATHY H. BRANDLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4570 CTY. HWY. 61, MOOSE LAKE, MN 55767
(218) 485-4491
(218) 485-4724
Mailing address
4570 CTY. HWY. 61, MOOSE LAKE, MN 55767
(218) 485-4491
(218) 485-4724
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46671
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014934900
—
MN
Enumeration date
07/12/2006
Last updated
12/04/2012
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