Individual
JENNIFER WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
420 DELAWARE ST SE, PHILLIPS WANGENSTEEN BLDG, 14TH FLOOR, SUITE 100, MINNEAPOLIS, MN 55455-0341
(612) 626-5031
(612) 625-3238
Mailing address
420 DELAWARE ST SE, PHILLIPS WANGENSTEEN BLDG, 14TH FLOOR, SUITE 100, MINNEAPOLIS, MN 55455-0341
(612) 626-5031
(612) 625-3238
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
63365
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2014
Last updated
07/29/2020
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