| |
901 Second St S Suite A Minneapolis MN 55415 | |
(612) 273-6089 | |
(612) 339-1890 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 901 Second St S, Minneapolis, Minnesota |
Authorized Official Name and Position | William Sibert (CFO) |
Authorized Official Contact | 6128840600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 860217 Minneapolis MN 55486-0217 Ph: (763) 782-6400 | 901 Second St S Suite A Minneapolis MN 55415 Ph: (612) 273-6089 |
NPI Number | 1124274527 |
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Provider Enumeration Date | 08/18/2008 |
Last Update Date | 11/21/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124274527 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (Minnesota) | Secondary |
261QP2300X | Clinic/center - Primary Care | (Minnesota) | Primary |
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