Most Relevant Information
Provider Data
| NPI Number: | 1003677105 |
| Provider Name: | JARED WUNDERLICH |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/17/2024 |
| Last Updated: | 01/17/2024 |
Provider Practice Location
1910 AGA DR
ALEXANDRIA
MN
563081796
Practice Location Phone/Fax
| Phone: | 2182874338 |
| Fax: |
Provider Mailing Location
1547 30TH AVE S
MOORHEAD
MN
565605149
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |