Individual
DANIEL FLETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 33RD AVE N SUITE 390, WAITE PARK, MN 56387-5638
(320) 654-6711
Mailing address
PO BOX 123, SARTELL, MN 56377-0123
(320) 654-6711
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
BC719405
MN
Other
Enumeration date
09/14/2022
Last updated
04/30/2024
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