Individual
JODY D ROTHERMUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
415 JEFFERSON ST N, WADENA, MN 56482-1264
(218) 631-3510
Mailing address
1037 1ST ST SE, WADENA, MN 56482-1808
(701) 318-9651
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/20/2020
Last updated
04/27/2022
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