Individual
MARC LANE WOLFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1148 GRAND AVENUE, ST. PAUL, MN 55105
(651) 690-5352
Mailing address
1148 GRAND AVENUE, ST. PAUL, MN 55105
(651) 690-5352
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R 203090-0
MN
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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