Individual
SETH HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16794 INTERLACHEN CT, LAKEVILLE, MN 55044-5849
(952) 412-0002
Mailing address
16794 INTERLACHEN CT, LAKEVILLE, MN 55044-5849
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9115614
FL
Other
Enumeration date
03/10/2022
Last updated
03/10/2022
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