Individual
MR. PAUL ANTHONY KUSTERMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
929 DUCHESS LN, APPLE VALLEY, MN 55124-8915
(952) 891-5713
Mailing address
929 DUCHESS LN, APPLE VALLEY, MN 55124-8915
(952) 891-5713
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1019588
MN
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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