| |
2925 Chicago Ave Minneapolis MN 55407-1321 | |
(612) 262-9000 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 2925 Chicago Ave, Minneapolis, 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 |
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Po Box 43 Mail Route 10860 Minneapolis MN 55440-0043 Ph: (612) 262-1166 | 2925 Chicago Ave Minneapolis MN 55407-1321 Ph: (612) 262-9000 |
NPI Number | 1649563321 |
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Provider Enumeration Date | 05/27/2011 |
Last Update Date | 03/22/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649563321 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
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