Individual
JEFFREY WOLLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 255-6303
Mailing address
1824 STAR DR, SAUK RAPIDS, MN 56379-2580
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7420
MN
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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