Individual
JEREMY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 S BIRCH AVE, HALLOCK, MN 56728-4215
(218) 843-3612
Mailing address
1010 S BIRCH AVE, HALLOCK, MN 56728-4215
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103234
MN
Other
Enumeration date
03/13/2024
Last updated
03/13/2024
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