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Individual

AUSTIN REWERTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
X

Contact information

Practice address
3401 ROUND LAKE BLVD NW, ANOKA, MN 55303-3315
(612) 509-7113
Mailing address
15274 SWALLOW ST NW, ANDOVER, MN 55304-3432

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
10/09/2025
Last updated
10/09/2025
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