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8675 Valley Creek Rd Woodbury MN 55125-2337 | |
| (651) 241-3000 | |
| (651) 241-3500 |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 8675 Valley Creek Rd, Woodbury, Minnesota |
| Authorized Official Name and Position | Dominica Tallarico (COO) |
| Authorized Official Contact | 6122222222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 43 Mail Route 10202 Minneapolis MN 55440-0043 Ph: (612) 262-1166 | 8675 Valley Creek Rd Woodbury MN 55125-2337 Ph: (651) 241-3000 |
| NPI Number | 1497279756 |
|---|---|
| Provider Enumeration Date | 07/28/2017 |
| Last Update Date | 03/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497279756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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