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General NPI Number Information
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NPI Number | 1750686200
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Entity Type | Organization
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Legal Business Name | BRAULT CONSTRUCTION
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Dates
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Enumeration Date | 01/13/2011
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 24751 330TH ST SW
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City | CROOKSTON
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State | MN
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Zip | 56716-8817
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Country | US
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Telephone | 218-289-4938
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Fax |
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Provider Business Mailing Address
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Address Line | 24751 330TH ST SW
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City | CROOKSTON
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State | MN
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Zip | 56716-8817
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Country | US
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Telephone | 218-289-4938
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Fax |
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Authorized Official
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Title or Position | BOOK KEEPER
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Name | KARI BRAULT
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Credential |
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Telephone | 218-289-4938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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