Organization
ANDREW FAUTSCH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW MARK FAUTSCH DC (PRESIDENT)
(877) 442-4476
Entity
Organization
Contact information
Practice address
12670 BASS LAKE RD, MAPLE GROVE, MN 55369-6380
(877) 442-4476
Mailing address
12670 BASS LAKE RD, MAPLE GROVE, MN 55369-6380
(877) 442-4476
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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