KISUK BAE WIRTZ

DETROIT LAKES, MN
NPI1457672800
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: MN  L48823-7)
Enumeration Date2010-06-21
Last Update Date2010-06-21
Business Address
Mrs. KISUK BAE WIRTZ
114 FRAZEE ST E 47854 SWISS LANE
DETROIT LAKES, MN 56501-3502
Phone number: 218-573-3898
Mailing Address
Mrs. KISUK BAE WIRTZ
PO BOX 884 47854 SWISS LANE
PONSFORD, MN 56575
Phone number: 218-573-3898
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