| Mckziel Clinic Inc | |
|
287 Marschall Rd Suite 204 Shakopee MN 55379-1686 | |
| (952) 445-7430 | |
| (952) 445-7430 |
| Full Name | Mckziel Clinic Inc |
|---|---|
| Speciality | Psychologist |
| Location | 287 Marschall Rd, Shakopee, Minnesota |
| Authorized Official Name and Position | Creighton John Mckowen (OWNER) |
| Authorized Official Contact | 9524457430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mckziel Clinic Inc 287 Marschall Rd Suite 204 Shakopee MN 55379-1686 Ph: (952) 445-7430 | Mckziel Clinic Inc 287 Marschall Rd Suite 204 Shakopee MN 55379-1686 Ph: (952) 445-7430 |
| NPI Number | 1487794194 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487794194 | NPI | - | NPPES |
| 61-15251 | Other | MN | UBH |
| 30505MC | Other | MN | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP1413 (Minnesota) | Primary |
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