Individual
BRIAN MCDONELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
2795 PILOT KNOB RD, SUITE 100, EAGAN, MN 55121-1119
(651) 994-9644
(651) 994-8962
Mailing address
4058 DEERWOOD TRL, EAGAN, MN 55122-1889
(651) 994-9644
(651) 994-8962
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6344
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6403435
MEDICA
MN
01
—
96556MC
BCBS
MN
01
—
HP41245
HEALTH PARTNERS
MN
Enumeration date
02/08/2007
Last updated
07/09/2007
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