Individual
MR. BRANT MICHAEL BOEKELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
717 S STATE ST, FAIRMONT, MN 56031-4469
(507) 238-4949
(507) 238-3385
Mailing address
717 S STATE ST, FAIRMONT, MN 56031-4469
(507) 238-4949
(507) 238-3385
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2314
MN
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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