Most Relevant Information
Provider Data
| NPI Number: | 1003419003 |
| Provider Name: | JACK H DUFFY |
| Entity Type: | Individual |
| Taxonomy Code: | 174H00000X |
| Specialty: | Health Educator |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/20/2020 |
| Last Updated: | 11/20/2020 |
Provider Practice Location
56- 66 1/2 WAY NE
FRIDLEY
MN
55432
Practice Location Phone/Fax
| Phone: | 7633819936 |
| Fax: |
Provider Mailing Location
56- 66 1/2 WAY NE
FRIDLEY
MN
55432
Provider Mailing Phone/Fax
| Phone: | 7633819936 |
| Fax: |