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14101 Fairview Dr Suite 300 Burnsville MN 55337-4590 | |
(612) 273-5400 | |
(612) 273-9945 |
Full Name | |
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Speciality | Clinic/center |
Location | 14101 Fairview Dr, Burnsville, Minnesota |
Authorized Official Name and Position | Maureen Ring (DIRECTOR NETWORK RELATIONS) |
Authorized Official Contact | 6126726740 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 9372 Minneapolis MN 55440-9372 Ph: (612) 672-5390 | 14101 Fairview Dr Suite 300 Burnsville MN 55337-4590 Ph: (612) 273-5400 |
NPI Number | 1992075501 |
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Provider Enumeration Date | 01/12/2012 |
Last Update Date | 10/04/2023 |
Identifier | Type | State | Issuer |
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1992075501 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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