| Apple Valley Medical Center Sleep Lab | |
|
15100 Galaxie Ave Apple Valley MN 55124 | |
| (952) 432-6161 | |
| (952) 891-3921 |
| Full Name | Apple Valley Medical Center Sleep Lab |
|---|---|
| Speciality | Family Medicine |
| Location | 15100 Galaxie Ave, Apple Valley, Minnesota |
| Authorized Official Name and Position | Mark Pottenger (ADMINISTRATOR) |
| Authorized Official Contact | 9529539285 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Apple Valley Medical Center Sleep Lab 14655 Galaxie Ave Apple Valley MN 55124 Ph: (952) 432-6161 | Apple Valley Medical Center Sleep Lab 15100 Galaxie Ave Apple Valley MN 55124 Ph: (952) 432-6161 |
| NPI Number | 1346550555 |
|---|---|
| Provider Enumeration Date | 10/21/2010 |
| Last Update Date | 06/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346550555 | NPI | - | NPPES |
| 5CB22AP | Other | BCBS | |
| 22345AP | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 723 (Minnesota) | Primary |
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