Individual
DAN VLAISAVLJEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3643 BAILEY RIDGE CT, WOODBURY, MN 55125-8461
(651) 698-8615
Mailing address
3643 BAILEY RIDGE CT, WOODBURY, MN 55125-8461
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R 118957-7
MN
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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