Individual
KAILEY WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 CONEY ST W, PERHAM, MN 56573-2102
(218) 347-1200
Mailing address
1000 CONEY ST W, PERHAM, MN 56573-2102
(218) 347-1200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
59624
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2012
Last updated
02/15/2016
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