Individual
STEPHAN LAWRENCE WASMUNDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
207 TWIFORD ST SW, CHATFIELD, MN 55923-1235
(507) 867-4925
Mailing address
207 TWIFORD ST SW, CHATFIELD, MN 55923-1235
(507) 867-4925
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14383
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/15/2021
Last updated
03/21/2023
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