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1225215122
MARK W. ANDERSON
GRAND RAPIDS, MN
NPI
1225215122
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 302045)
Enumeration Date
2008-01-23
Last Update Date
2008-01-23
Business Address
-- MARK W. ANDERSON LADC
1215 SE 7TH AVE
GRAND RAPIDS, MN 55744-4201
Phone number: 218-327-1105
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Mailing Address
-- MARK W. ANDERSON LADC
1215 SE 7TH AVE
GRAND RAPIDS, MN 55744-4201
Phone number:
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