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Dr. Brian John Isetts

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NPI Number Detailed Information

Provider Information:

Name: Dr. Brian John Isetts
Gender: M
Provider License Number If Given: 113541-1

NPI Information:

NPI: 1164425112
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: 3510 WILD TURKEY RD
Red Wing, MN 55066
Phone Number: 6513858353
Fax Number:

Provider Business Practice Location Address:

Address: 308 HARVARD ST SE RM 7-175
Minneapolis, MN 55455
Phone Number: 6126242140
Fax Number: 6126259931

Provider Taxonomy:

Primary: 1835P1200X
Secondary (if any):
State: MN

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