Individual
CODY RAY PLAISANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
560 S MAPLE ST STE 200, WACONIA, MN 55387-1757
(952) 442-2163
Mailing address
560 S MAPLE ST STE 200, WACONIA, MN 55387-1757
(952) 442-2163
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13177
MN
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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