| Provisional Health And Rehabilitative Services Llc | |
|
12970 Cardinal Creek Rd Eden Prairie MN 55346-1936 | |
| (952) 687-9064 | |
| Not Available |
| Full Name | Provisional Health And Rehabilitative Services Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 12970 Cardinal Creek Rd, Eden Prairie, Minnesota |
| Authorized Official Name and Position | Ali Jama (OWNER) |
| Authorized Official Contact | 9526879064 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provisional Health And Rehabilitative Services Llc 12970 Cardinal Creek Rd Eden Prairie MN 55346-1936 Ph: () - | Provisional Health And Rehabilitative Services Llc 12970 Cardinal Creek Rd Eden Prairie MN 55346-1936 Ph: (952) 687-9064 |
| NPI Number | 1841966116 |
|---|---|
| Provider Enumeration Date | 08/18/2021 |
| Last Update Date | 08/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841966116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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