Individual
BETHANY CHAPIN CORLISS DA ROCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 454-3650
Mailing address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 454-3650
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
57714
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2011
Last updated
10/20/2014
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