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KATHRYN J CLUSIAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3605 MAYFAIR AVE, HIBBING, MN 55746-2935
(218) 362-6975
(218) 362-6989
Mailing address
3605 MAYFAIR AVE, HIBBING, MN 55746-2935
(218) 362-6975
(218) 362-6989

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9468
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
751170100
MN
01
82G70CL
BCBS
MN
Enumeration date
08/12/2006
Last updated
10/08/2008
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