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1225056955
JEFFREY L BLICKENSTAFF
PERHAM, MN
NPI
1225056955
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MN 27074)
Enumeration Date
2006-07-18
Last Update Date
2012-01-05
Business Address
JEFFREY L BLICKENSTAFF MD
665 3RD ST SW
PERHAM, MN 56573-1108
Phone number: 218-346-4040
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Mailing Address
JEFFREY L BLICKENSTAFF MD
665 3RD ST SW
PERHAM, MN 56573-1108
Phone number: 218-346-4040
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