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616 Rice St Suite B Saint Paul MN 55103-1827 | |
(651) 222-2772 | |
(651) 222-2829 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 616 Rice St, Saint Paul, Minnesota |
Authorized Official Name and Position | Blong Bliaxa Vang (OWNER/CHIROPRACTOR) |
Authorized Official Contact | 6512222772 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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616 Rice St Suite B Saint Paul MN 55103-1827 Ph: (651) 222-2772 | 616 Rice St Suite B Saint Paul MN 55103-1827 Ph: (651) 222-2772 |
NPI Number | 1053591586 |
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Provider Enumeration Date | 11/13/2007 |
Last Update Date | 11/13/2007 |
Identifier | Type | State | Issuer |
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1053591586 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 4471 (Minnesota) | Primary |
Premiere Mental Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St Ste 290, Saint Paul, MN 55102 Phone: 763-913-8125 |