Provider Demographics
NPI:1952523912
Name:WALBERG, JOCELYNE M
Entity Type:Individual
Prefix:
First Name:JOCELYNE
Middle Name:M
Last Name:WALBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16395 261ST AVE
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55309
Mailing Address - Country:US
Mailing Address - Phone:763-633-5555
Mailing Address - Fax:
Practice Address - Street 1:200 5TH ST NW
Practice Address - Street 2:SUITE D
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-1917
Practice Address - Country:US
Practice Address - Phone:763-633-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath