Individual
DANIEL LUSSENHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 WABASHA ST S, SAINT PAUL, MN 55107-1805
(651) 293-8100
Mailing address
8170 33RD AVE S, BLOOMINGTON, MN 55425-4516
(651) 293-8100
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
28547
MN
Other
Enumeration date
12/06/2005
Last updated
05/11/2020
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