Individual
BRANDI MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 E CAPITOL WAY, BISMARCK, ND 58501-2218
(701) 751-0410
Mailing address
1615 E CAPITOL WAY, BISMARCK, ND 58501-2218
(701) 751-0410
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1334
ND
Other
Enumeration date
05/13/2014
Last updated
09/20/2023
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