Individual
TINA ANN MAUSOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 4TH AVE N, FERGUS FALLS, MN 56537
(218) 998-3778
(218) 998-3187
Mailing address
27156 GREENWOOD AISLE CIRCLE, DEERWOOD, MN 56444
(218) 678-9033
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L46676-7
MN
Other
Enumeration date
09/23/2009
Last updated
09/23/2009
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