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1184260812
COLLIN ROSS MODAHL
ALEXANDRIA, MN
NPI
1184260812
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: MN LP6478)
Enumeration Date
2019-11-18
Last Update Date
2019-11-18
Business Address
Dr. COLLIN ROSS MODAHL LP
324 BROADWAY ST STE 206
ALEXANDRIA, MN 56308-1482
Phone number: 320-762-1762
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Mailing Address
Dr. COLLIN ROSS MODAHL LP
324 BROADWAY ST STE 206
ALEXANDRIA, MN 56308-1482
Phone number: 320-762-1762
Copy
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