Individual
MRS. LUANN JOYCE CHARBONEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
710 S KENWOOD AVE, MOOSE LAKE, MN 55767-9405
(218) 485-5627
Mailing address
710 S KENWOOD AVE, MOOSE LAKE, MN 55767-9405
(218) 485-5627
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4201
MN
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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