Individual
TERRY JOHN PUCHALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDMS
Contact information
Practice address
720 HIGHWAY 10 S, SAINT CLOUD, MN 56304-1800
(320) 253-9454
(320) 253-9454
Mailing address
720 HIGHWAY 10 S, SAINT CLOUD, MN 56304-1800
(320) 253-9454
(320) 253-9454
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
108145
MN
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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