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7901 Xerxes Ave S Suite 116 Bloomington MN 55431-1253 | |
| (952) 888-2024 | |
| (952) 888-3985 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 7901 Xerxes Ave S, Bloomington, Minnesota |
| Authorized Official Name and Position | Robert Andrew Mccoy (VP REVENUE MANAGEMENT) |
| Authorized Official Contact | 6126726594 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 9372 Minneapolis MN 55440-9372 Ph: (612) 672-5390 | 7901 Xerxes Ave S Suite 116 Bloomington MN 55431-1253 Ph: (952) 888-2024 |
| NPI Number | 1073890398 |
|---|---|
| Provider Enumeration Date | 11/15/2011 |
| Last Update Date | 10/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073890398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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