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Brook Fantaw
NPI 1427816784 · on the registry since 2024 · sole proprietor
Practice
- Address
- 3621 Williston Rd
Minnetonka, MN 55345 - Phone
- (952) 457-7546
Registry record
- Primary taxonomy
- 251E00000X
251E00000X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-03-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota