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Individual

JACQUELINE BRAATEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L/PTA

Contact information

Practice address
804 WRIGHT ST, BRAINERD, MN 56401-4441
(218) 829-1407
Mailing address
13620 VISTA OAKS DR SW, PILLAGER, MN 56473-2491
(218) 820-7539

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-3
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A-3
PHYSICAL THERAPIST ASSISTANT
MN
Enumeration date
07/14/2021
Last updated
07/14/2021
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