JILLENE MARIE BANTAU
Individual Provider (NPI-1)
Active
Specialist
Provider Information
- NPI Number
1225528664- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1806 E FIR AVE STE 200, FERGUS FALLS, MN, 565373921
- Phone
- (218) 998-2992
Specialties & Taxonomies
Specialist
Primary
All Addresses
MAILING
891 BELSLY BLVD
MOORHEAD, MN, 565605055