| |
5109 36th Ave N Crystal MN 55422-2007 | |
(763) 587-7900 | |
(763) 587-7989 |
Full Name | |
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Speciality | Family Medicine |
Location | 5109 36th Ave N, Crystal, Minnesota |
Authorized Official Name and Position | Scott Richard Colson (PRESIDENT) |
Authorized Official Contact | 7635877900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5109 36th Ave N Crystal MN 55422-2007 Ph: (763) 587-7900 | 5109 36th Ave N Crystal MN 55422-2007 Ph: (763) 587-7900 |
NPI Number | 1639643455 |
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Provider Enumeration Date | 01/15/2019 |
Last Update Date | 12/23/2022 |
Identifier | Type | State | Issuer |
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1639643455 | NPI | - | NPPES |
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