Richard B Hathaway, PAC

NPI #1710961966 in Blaine, Minnesota

Provider Information

NPI Number
1710961966
Entity Type
Individual
Name
Richard B Hathaway, PAC
Gender
Not Specified
Sole Proprietor
Not Answered
Primary Specialty
Physician Assistant
Credential
PAC
Enumeration Date
Dec 1, 2005
Last Updated
Jul 8, 2007

Practice Location

Address
12175 ABERDEEN ST NE
City
Blaine
ZIP Code
55449-4717
Phone
(763) 785-4200

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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