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NPI Code Detail

MEDICARE: MONICA RAELYNN RODEL

MEDICARE: MONICA RAELYNN RODEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther Technician

General Provider Information

NPI Number : 1720622962
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONICA RAELYNN RODEL
Provider Business Mailing Address
First Line : 318 1ST AVE SW APT 609B
Second Line :
City : ROCHESTER
State : MN
Zip : 55902-3310
Country : US
Telephone Number : 320-292-4527
Fax Number :
Provider Business Practice Location Address
First Line : 1470 INDUSTRIAL DR NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-0700
Country : US
Telephone Number : 507-322-7751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2019
Last Update Date : 10/31/2019

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