Individual
JOHN CHARLES BRECOUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16560 JACKDAW PATH, LAKEVILLE, MN 55044-4642
(952) 237-9138
Mailing address
16560 JACKDAW PATH, LAKEVILLE, MN 55044-4642
(952) 237-9138
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2328256
MN
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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