Bantau, Jillene Marie

Bantau, Jillene Marie is an individual health care provider with primary practice located at 1806 E Fir Ave Ste 200 , Fergus Falls MN 56537-3921. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Bantau, Jillene Marie can be contacted via phone (218) 998-2992.

Contact Information

Primary practice address
1806 E Fir Ave Ste 200 Fergus Falls MN 56537-3921
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1225528664
LBN Legal business name Bantau, Jillene Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2018
Last updated Aug 11th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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