Individual
JEFF DAHLQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
135 PINE TREE DR, BIGFORK, MN 56628
(218) 743-3232
Mailing address
20 5TH ST SE, COOK, MN 55723-9702
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12220
MN
363AM0700X
Medical Physician Assistant
2596
MN
Other
Enumeration date
10/20/2016
Last updated
10/11/2021
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