Individual
BRAYDE JAMES LIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1521 NORTHWAY DR STE 116, SAINT CLOUD, MN 56303-1274
(320) 654-9838
(320) 654-0981
Mailing address
415 36TH ST STE 100, PARKERSBURG, WV 26101-1005
(304) 917-3660
(304) 917-3674
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12774
MN
225100000X
Physical Therapist
1360599
TX
Other
Enumeration date
07/13/2022
Last updated
07/21/2022
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