Provider Information for 1275636540
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MORRIS PATZLAFF LICSW
Sex: Male
NPI: 1275636540
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1275636540 | ||||||||
| Enumeration Date | 2006-09-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 216 E LUVERNE ST PO BOX 686 LUVERNE, MN 56156-1610 United States Phone: 507-283-9511 | Fax:507-283-9514 | ||||||||
| Primary Practice Address | 1016 8TH AVENUE SW PIPESTONE, MN 56164 United States Phone: 507-825-5888 | Fax:507-825-5880 | ||||||||
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