Individual
JACK KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 RICE LAKE RD, DULUTH, MN 55811-4819
(218) 625-6400
Mailing address
810 1ST ST, PROCTOR, MN 55810-2705
(218) 341-5513
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7926
MN
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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