Individual
TANNER JESUS VERDUZCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12000 ELM CREEK BLVD N STE 300, MAPLE GROVE, MN 55369-7075
(952) 841-2345
(952) 841-2346
Mailing address
7235 OHMS LN, EDINA, MN 55439-2148
(952) 841-2345
(952) 841-2346
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/14/2021
Last updated
12/21/2023
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