Individual
MR. LORENZO ANGELO PAVOLONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4050 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2522
(763) 236-6000
Mailing address
1970 BOHLAND AVE, SAINT PAUL, MN 55116-1909
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14056
MN
Other
Enumeration date
04/22/2020
Last updated
10/19/2022
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