Individual
MARK J BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 234-7452
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0818
ND
2251X0800X
Orthopedic Physical Therapist
0818
ND
Other
Enumeration date
10/07/2014
Last updated
04/06/2022
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