Provider Demographics
NPI:1972182764
Name:JOHANDER CAPITAL GROUP LLC
Entity Type:Organization
Organization Name:JOHANDER CAPITAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUERNFEIND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-273-4207
Mailing Address - Street 1:524 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:OSSEO
Mailing Address - State:MN
Mailing Address - Zip Code:55369-1129
Mailing Address - Country:US
Mailing Address - Phone:763-273-4207
Mailing Address - Fax:763-273-4934
Practice Address - Street 1:524 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:MN
Practice Address - Zip Code:55369-1129
Practice Address - Country:US
Practice Address - Phone:763-273-4207
Practice Address - Fax:763-273-4934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health