Individual
MR. DUANE OLIVER KOIVISTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
11400 JULIANNE AVE N, STILLWATER, MN 55082-9436
(651) 426-3300
(651) 426-0419
Mailing address
2532 1ST AVE S, #104, MINNEAPOLIS, MN 55404-4368
(612) 825-2905
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L 63350-3
MN
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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