NPI 1003419912

Justin Vern Perreault

Practitioner Student in an Organized Health Care Education/Training Program Moorhead, MN

Practice location

Address: 925 36th St. S., Moorhead, MN 56560-5656
Phone: (701) 318-1116
Mailing address: 925 36th St. S., Moorhead, MN 56560

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003419912
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Nov 2020
Record last updated: 21 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.