| North Suburban Healthcare Pa | |
|
8171 University Ave Ne Fridley MN 55432-1865 | |
| (763) 754-2573 | |
| (763) 754-0128 |
| Full Name | North Suburban Healthcare Pa |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 8171 University Ave Ne, Fridley, Minnesota |
| Authorized Official Name and Position | Richard Ray Tollefson (OWNER) |
| Authorized Official Contact | 7637542573 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Suburban Healthcare Pa 8171 University Ave Ne Fridley MN 55432-1865 Ph: (763) 754-2573 | North Suburban Healthcare Pa 8171 University Ave Ne Fridley MN 55432-1865 Ph: (763) 754-2573 |
| NPI Number | 1760651038 |
|---|---|
| Provider Enumeration Date | 02/21/2008 |
| Last Update Date | 02/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760651038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 2478 (Minnesota) | Primary |
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