Individual
CORALYN MARY LASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
106 4TH AVENUE NORTH, FERGUS FALLS, MN 56537-1034
(218) 998-3778
(218) 998-3187
Mailing address
2558 LITTLE ROCK ROAD, SAUK RAPIDS, MN 56379
(320) 292-1939
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L-069172-3
MN
Other
Enumeration date
03/22/2010
Last updated
03/22/2010
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