Individual
JACQUELINE LOIS ZORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40520 CTY. HWY. 34, OGEMA, MN 56569
(218) 983-4300
(218) 983-6217
Mailing address
40520 CTY. HWY. 34, OGEMA, MN 56569-9612
(218) 983-4300
(218) 983-6217
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
495957
MN
2471B0102X
Bone Densitometry Radiologic Technologist
495957
MN
2471M2300X
Mammography Radiologic Technologist
495957
MN
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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