Individual
LISA JO JAMSA TOLLEFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
929 CENTRAL AVE NW, EAST GRAND FORKS, MN 56721
(218) 773-6800
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10765
ND
207Q00000X
Family Medicine Physician
Primary
51723
MN
207Q00000X
Family Medicine Physician
RL10246
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10562
—
ND
Enumeration date
04/13/2007
Last updated
03/07/2024
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