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Ambulatory Health Care Facilities Clinic/Center Multi-Specialty

Provider NPI: 1760541700

Organization Information:
Organization is Subpart

Practice Location:
Tel: 651-636-9443  Fax: --

Business Mailing Address:
Tel: 651-291-2848  Fax: 651-325-2174

NPI Information:
NPI: 1760541700
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N261QM1300XAmbulatory Health Care Facilities
Durable Medical Equipment & Medical Supplies
Prosthetic/Orthotic Supplier
Durable Medical Equipment & Medical Supplies

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 332BC3200X





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