Timothy Richard Fresonke, PA-C

NPI #1548945397 in Perham, Minnesota

Provider Information

NPI Number: 1548945397
Entity Type: Individual
Name: Timothy Richard Fresonke, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jun 20, 2023
Last Updated: Jun 25, 2023

Practice Location

Address: 1000 CONEY ST W
City: Perham
State: Minnesota
ZIP Code: 56573-2102
Phone: (218) 347-1400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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