Revive Pain Centers Pa | |
14525 Highway 7 Ste 375 Minnetonka MN 55345-3741 | |
(651) 308-6190 | |
Not Available |
Full Name | Revive Pain Centers Pa |
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Speciality | Family Medicine |
Location | 14525 Highway 7 Ste 375, Minnetonka, Minnesota |
Authorized Official Name and Position | Troy Stuckey (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 6513086190 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Revive Pain Centers Pa 14525 Highway 7 Ste 375 Minnetonka MN 55345-3741 Ph: (651) 308-6190 | Revive Pain Centers Pa 14525 Highway 7 Ste 375 Minnetonka MN 55345-3741 Ph: (651) 308-6190 |
NPI Number | 1760005771 |
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Provider Enumeration Date | 05/26/2020 |
Last Update Date | 05/26/2020 |
Identifier | Type | State | Issuer |
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1760005771 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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