| Avitity, Inc. | |
|
315 Waite Ave S Suite 301 Waite Park MN 56387-1468 | |
| (612) 249-3656 | |
| Not Available |
| Full Name | Avitity, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 315 Waite Ave S, Waite Park, Minnesota |
| Authorized Official Name and Position | Michael Dwyer-clonts (OWNER) |
| Authorized Official Contact | 6122493656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avitity, Inc. 315 Waite Ave S Suite 301 Waite Park MN 56387-1468 Ph: (612) 249-3656 | Avitity, Inc. 315 Waite Ave S Suite 301 Waite Park MN 56387-1468 Ph: (612) 249-3656 |
| NPI Number | 1518407634 |
|---|---|
| Provider Enumeration Date | 03/08/2017 |
| Last Update Date | 03/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518407634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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