Individual
JIM HAROLD KIRCHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
2480 S COUNTY ROAD 45, OWATONNA, MN 55060-5113
(612) 454-2130
(507) 451-2705
Mailing address
2480 S COUNTY ROAD 45, OWATONNA, MN 55060-5113
(612) 454-2130
(507) 451-2705
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302919
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C543034150512
DRIVER'S LICENSE
MN
Enumeration date
10/04/2017
Last updated
10/04/2017
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