Individual
BRAYTON KIEDROWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1700 SAINT FRANCIS AVE, SHAKOPEE, MN 55379
(952) 831-8742
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
88752
MT
207QS0010X
Sports Medicine (Family Medicine) Physician
02006537A
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
77987
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2017
Last updated
09/13/2024
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