Individual
JIETHYL PIERSAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2512 S 7TH ST, MINNEAPOLIS, MN 55454-1404
(612) 273-4277
Mailing address
11926 UNDERCLIFF ST NW, COON RAPIDS, MN 55433-1628
(952) 913-9302
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104824
MN
Other
Enumeration date
05/31/2017
Last updated
05/31/2017
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