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Individual

CHRISTINE VANJAECKEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
434 HAYWARD AVE N, OAKDALE, MN 55128
(201) 704-0163
Mailing address
2524 PILLSBURY AVENUE S, MINNEAPOLIS, MN 55404
(201) 704-0163

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10048
MN
174400000X
Specialist
SL010403
PA

Other

Enumeration date
06/06/2012
Last updated
07/12/2018
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