Individual
MS. DAWN RENEE RESTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBO
Contact information
Practice address
450 1ST AVE S, PERHAM, MN 56573-1601
(218) 205-4330
(218) 346-1237
Mailing address
450 1ST AVE S, PERHAM, MN 56573-1601
(218) 205-4330
(218) 346-1237
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199999
MEDICA PROVIDER NUMBER
MN
Enumeration date
04/12/2007
Last updated
07/08/2007
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