Individual
MRS. KATHI JO TRAVAILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRDA
Contact information
Practice address
304 BELLE AVE, MANKATO, MN 56001-5250
(507) 344-8698
(507) 344-8759
Mailing address
605 HILLCREST AVE STE 130, OWATONNA, MN 55060-3680
(507) 451-0290
(507) 451-0291
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
A9553
MN
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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