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Individual

DR. JONATHAN PAUL GERVAIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AU.D

Contact information

Practice address
2015 LAKEVIEW DR, DULUTH, MN 55803-2414
(218) 724-5027
Mailing address
2015 LAKEVIEW DRIVE, DULUTH, MN 55803
(218) 724-5027

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
332156
WI
231H00000X
Audiologist
Primary
6443
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
443928700
MN
Enumeration date
06/16/2006
Last updated
05/31/2012
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