Individual
LANA R BAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36779 240TH AVE SE, MCINTOSH, MN 56556-9258
(218) 280-8384
Mailing address
36779 240TH AVE SE, MCINTOSH, MN 56556-9258
(218) 280-8384
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
01/13/2011
Last updated
01/13/2011
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