| |
4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 | |
(763) 236-6000 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Multi-specialty |
Location | 4050 Coon Rapids Blvd Nw, Coon Rapids, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801431416 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | (* (Not Available)) | Secondary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 43, Mail Route 10860, Minneapolis, MN 55440-0043 Ph: (612) 262-1166 | 4050 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2522 Ph: (763) 236-6000 |