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1053073080
MAXWELL C SAMUELSON
MANKATO, MN
NPI
1053073080
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-10-07
Last Update Date
2022-04-27
Business Address
MAXWELL C SAMUELSON
1720 BASSETT DR
MANKATO, MN 56001-6569
Phone number: 507-565-0179
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Mailing Address
MAXWELL C SAMUELSON
501 MADISON AVE
MANKATO, MN 56001-6109
Phone number: 507-682-7100
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