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ADDICTION CARE PRACTITIONERS, PA

Physicians Anesthesiology Addiction Medicine

Provider NPI: 1699054361

Organization Information:
Organization Name:  ADDICTION CARE PRACTITIONERS, PA
Organization is not Subpart
Authorized Official:  ARTHUR LEE FRETAG  ADMINISTRATOR  612-782-0900

Practice Location:
2904 JOHNSON ST NE  MINNEAPOLIS, MN 55418-2234 US
Tel: 612-782-0900  Fax: 612-788-4930

Business Mailing Address:
17010 COUNTY ROAD 47  PLYMOUTH, MN 55446-1124 US
Tel: 763-559-1110  Fax: 763-559-7668

NPI Information:
NPI: 1699054361
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207LA0401XPhysicians
Anesthesiology
Addiction Medicine
MN22350

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 207LA0401X

Type:

Classification:



Definition:



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