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1972065928
JON M HOLTHUSEN
SAINT CLOUD, MN
NPI
1972065928
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-04-01
Last Update Date
2019-04-01
Business Address
Mr. JON M HOLTHUSEN LADC
713 ANDERSON AVE
SAINT CLOUD, MN 56303-2048
Phone number: 320-229-3760
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Mailing Address
Mr. JON M HOLTHUSEN LADC
713 ANDERSON AVE
SAINT CLOUD, MN 56303-2048
Phone number: 320-229-3760
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