Individual
BRANDON JAMES TETRAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
UNIVERSITY OF NORTH DAKOTA, 1301 N COLUMBIA RD, GRAND FORKS, ND 58202-0001
(701) 610-1060
Mailing address
UNIVERSITY OF NORTH DAKOTA, 1301 N COLUMBIA RD, GRAND FORKS, ND 58202
(701) 610-1060
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2601001062
MI
2255A2300X
Athletic Trainer
Primary
953-22
ND
Other
Enumeration date
11/03/2010
Last updated
08/15/2023
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