Individual
VONDA EIDENSCHINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10403
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356508139
—
MN
Enumeration date
05/20/2008
Last updated
12/06/2011
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