Individual
MR. JEFFREY KOROLCHUK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
2204 LEXINGTON AVE N APT 10, ROSEVILLE, MN 55113-4355
(612) 578-9260
Mailing address
2204 LEXINGTON AVE N APT 10, ROSEVILLE, MN 55113-4355
(612) 578-9260
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
MN
Other
Enumeration date
03/10/2016
Last updated
03/10/2016
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