Individual
MR. JUN MANALO HERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1406 SIXTH AVENUE NORTH, ST CLOUD, MN 56303-1901
(612) 262-1166
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
(320) 656-7115
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
43953
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
928151700
—
MN
Enumeration date
07/27/2006
Last updated
03/10/2021
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