Individual
JEFFREY THOMAS HARDWIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 KEENAN DR, INTERNATIONAL FALLS, MN 56649-2181
(218) 283-9431
(218) 285-6275
Mailing address
2501 KEENAN DR, INTERNATIONAL FALLS, MN 56649-2181
(218) 283-9431
(218) 285-6275
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
30109
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32404300
—
WI
05
—
709792100
—
MN
Enumeration date
07/07/2006
Last updated
07/08/2007
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