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Ambulatory Health Care Facilities Clinic/Center Multi-Specialty

Provider NPI: 1215032743

Organization Information:
Organization is Subpart
Authorized Official:  JOEN V CONDON  CHIEF FINANCIAL OFFICER  763-586-5839

Practice Location:
10000 ZANE AVE N  BROOKLYN PARK, MN 55443-1400 US
Tel: 763-572-5710  Fax: 763-569-6200

Business Mailing Address:
Tel: 763-572-5710  Fax: 763-571-3008

NPI Information:
NPI: 1215032743
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y261QM1300XAmbulatory Health Care Facilities

Other Provider Identifiers:

UCARE MN104022MN01

American Medical Association 2012 taxonomy code information

Code: 261QM1300X





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