Catalyst Medical Clinic Pa | |
204 Lewis Ave S Ste 201 Watertown MN 55388-4502 | |
(952) 955-1963 | |
(952) 955-1965 |
Full Name | Catalyst Medical Clinic Pa |
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Speciality | Clinic/center - Primary Care |
Location | 204 Lewis Ave S Ste 201, Watertown, Minnesota |
Authorized Official Name and Position | Scott M Jensen (PRESIDENT/OWNER) |
Authorized Official Contact | 9529551963 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Catalyst Medical Clinic Pa 29 E Main St Waconia MN 55387-1114 Ph: (952) 442-7015 | Catalyst Medical Clinic Pa 204 Lewis Ave S Ste 201 Watertown MN 55388-4502 Ph: (952) 955-1963 |
NPI Number | 1457456691 |
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Provider Enumeration Date | 09/13/2006 |
Last Update Date | 03/27/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457456691 | NPI | - | NPPES |
860567000 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 1540 (Minnesota) | Primary |