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Individual

MR. ANDREW TIMOTHY SHOFNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4849 4TH AVE, BROOKSTON, MN 55711-0317
(218) 453-5037
Mailing address
PO BOX 317, BROOKSTON, MN 55711-0317
(218) 453-5037

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
201343-3-AFC
MN
171M00000X
Case Manager/Care Coordinator
2013433AFC
MN

Other

Enumeration date
06/18/2010
Last updated
06/18/2010
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