Individual
BLAKE HUNTER CEDARLEAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
Mailing address
16832 LINDEN AVE, GRASSTON, MN 55030-4506
(651) 528-9173
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
13252
MN
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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