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Individual

JOSEPH VIDMAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
512 SKYLINE BLVD STE 1, CLOQUET, MN 55720-1199
(218) 879-4641
Mailing address
512 SKYLINE BLVD STE 1, CLOQUET, MN 55720-1199
(218) 879-4641

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2037767
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
2136
MN

Other

Enumeration date
12/04/2017
Last updated
01/25/2022
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