Individual
MR. JOHN S JAKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6490 EXCELSIOR BLVD, STE E400, ST LOUIS PARK, MN 55426-4705
(952) 993-3123
Mailing address
6465 WAYZATA BLVD, STE 315, ST LOUIS PARK, MN 55426-1728
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8835
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253605600
—
MN
Enumeration date
12/06/2005
Last updated
05/30/2008
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