Individual
MRS. JOELYN MARIE KLONCZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9839 54TH ST, CLEAR LAKE, MN 55319-9556
(320) 743-5495
Mailing address
9839 54TH ST, CLEAR LAKE, MN 55319-9556
(320) 743-5495
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1044577-2-AFC
MN
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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