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1790143980
LUKAS WAVRA
ALEXANDRIA, MN
NPI
1790143980
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MN 104542)
Enumeration Date
2016-02-03
Last Update Date
2016-02-03
Business Address
Mr. LUKAS WAVRA MOTR/L
1020 LARK ST
ALEXANDRIA, MN 56308-2219
Phone number: 320-759-5062
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Mailing Address
Mr. LUKAS WAVRA MOTR/L
1109 LARK ST APT 104
ALEXANDRIA, MN 56308-2332
Phone number: 218-686-3426
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