Individual
SHANNON JEAN WESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
512 SKYLINE BLVD, COMMUNITY MEMORIAL HOSPITAL, CLOQUET, MN 55720
(218) 879-4641
Mailing address
42 E OWATONNA ST, DULUTH, MN 55803-1804
(218) 724-2123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
49802
MN
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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