Individual
MR. BRYAN GEORGE DEMAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
720 4TH AVE S # 133, SAINT CLOUD, MN 56301-4498
(320) 308-2588
Mailing address
3087 OLYMPUS DR NE, SAUK RAPIDS, MN 56379-4411
(320) 247-3330
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1576
MN
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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