Individual
SYBILLA MATERLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20694 KEYSTONE AVE UNIT C, LAKEVILLE, MN 55044-6175
(612) 323-9989
Mailing address
20694 KEYSTONE AVE UNIT C, LAKEVILLE, MN 55044-6175
(612) 323-9989
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
817084
MN
Other
Enumeration date
04/13/2020
Last updated
04/13/2020
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