| Avanti Medical Group Of Minnesota Llc | |
|
1801 Market Dr Stillwater MN 55082-7599 | |
| (318) 465-5874 | |
| Not Available |
| Full Name | Avanti Medical Group Of Minnesota Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 1801 Market Dr, Stillwater, Minnesota |
| Authorized Official Name and Position | Amy Graham (VICE PRESIDENT MEDICAL AFFAIRS) |
| Authorized Official Contact | 3184655874 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avanti Medical Group Of Minnesota Llc 1755 S Naperville Rd Suite 100 Wheaton IL 60189-5844 Ph: (318) 465-5874 | Avanti Medical Group Of Minnesota Llc 1801 Market Dr Stillwater MN 55082-7599 Ph: (318) 465-5874 |
| NPI Number | 1578872974 |
|---|---|
| Provider Enumeration Date | 10/02/2010 |
| Last Update Date | 10/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578872974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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