| Apple Valley Medical Clinic, Ltd. | |
|
14655 Galaxie Ave Apple Valley MN 55124-8575 | |
| (952) 432-6161 | |
| Not Available |
| Full Name | Apple Valley Medical Clinic, Ltd. |
|---|---|
| Speciality | Family Medicine |
| Location | 14655 Galaxie Ave, Apple Valley, Minnesota |
| Authorized Official Name and Position | Mark Pottenger (ADMINISTRATOR) |
| Authorized Official Contact | 9529539285 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Apple Valley Medical Clinic, Ltd. 14655 Galaxie Ave Apple Valley MN 55124-8575 Ph: (952) 432-6161 | Apple Valley Medical Clinic, Ltd. 14655 Galaxie Ave Apple Valley MN 55124-8575 Ph: (952) 432-6161 |
| NPI Number | 1366754434 |
|---|---|
| Provider Enumeration Date | 07/06/2010 |
| Last Update Date | 06/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366754434 | NPI | - | NPPES |
| 858098 | Other | PREFERRED ONE | |
| 679251001 | Other | MEDICARE | |
| CE7163 | Other | RAILROAD MEDICARE | |
| 55108 | Other | HEALTHPARTNERS | |
| 22345AP | Other | BLUEE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 723 (Minnesota) | Primary |
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