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1710905351
STEPHEN R HIETALA
PERHAM, MN
NPI
1710905351
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MN 28147)
Enumeration Date
2006-07-18
Last Update Date
2011-11-17
Business Address
STEPHEN R HIETALA MD
665 3RD ST SW
PERHAM, MN 56573-1108
Phone number: 218-347-1200
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Mailing Address
STEPHEN R HIETALA MD
665 3RD ST SW
PERHAM, MN 56573-1108
Phone number: 218-347-1200
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