Individual
BENNETT JAY LEPEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
201 2ND ST NW, PLATO, MN 55370-5464
(320) 296-8657
Mailing address
201 2ND ST NW, PLATO, MN 55370-5464
(320) 296-8657
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3800
MN
Other
Enumeration date
12/06/2022
Last updated
07/22/2024
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