Individual
KENDALL DEWAYNE RICKLEFS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-2563
Mailing address
815 13TH AVE SE, #216, MINNEAPOLIS, MN 55414-1471
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
48744
MN
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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