Individual provider · NPI-1

Bradley Dean Borresen, RPH

Pharmacist · Mankato, MN

NPI number1013035450
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1013035450
Entity type
Individual (NPI-1)
Name
Bradley Dean Borresen
Credential
RPH
Sex
Male
Sole proprietor
No
Enumeration date
Mar 26, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist112214MNYes

Practice location

2010 Adams St
Mankato, MN 56001-6817

Phone 507-625-7565

Mailing address

2209 W Dream Dr
North Mankato, MN 56003-2305

Phone 507-387-3646

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