Individual
SUZANNE DETLEFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
905 MAPLECREST DR, MINNETRISTA, MN 55364-8935
(612) 924-3030
Mailing address
15349 FLORET WAY, APPLE VALLEY, MN 55124-3129
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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