Individual
MARK ROY HARSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
206 SPRUCE AVE NE, BUFFALO, MN 55313-2517
(763) 333-6075
Mailing address
206 SPRUCE AVE NE, BUFFALO, MN 55313-2517
(763) 333-6075
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
R201897-7
MN
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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