Individual
JUSTIN VERN PERREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
925 36TH ST. S., MOORHEAD, MN 56560-5656
(701) 318-1116
Mailing address
925 36TH ST. S., MOORHEAD, MN 56560
(701) 318-1116
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/21/2020
Last updated
11/21/2020
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