Individual
BRETT DAVID LACKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3050 CENTRE POINTE DR, ROSEVILLE, MN 55113
(952) 831-8742
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11403
MN
Other
Enumeration date
03/25/2019
Last updated
01/27/2026
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