Individual
JEREMY JOHN COLFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
13197 IVY ST, BECKER, MN 55308-4537
(763) 221-3863
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
824109
MN
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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