| Catalyst Medical Clinic Pa | |
|
204 Lewis Ave S Ste 201 Watertown MN 55388-4502 | |
| (952) 955-1963 | |
| (952) 955-1965 |
| Full Name | Catalyst Medical Clinic Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 204 Lewis Ave S Ste 201, Watertown, Minnesota |
| Authorized Official Name and Position | Scott M Jensen (PRESIDENT/OWNER) |
| Authorized Official Contact | 9529551963 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Catalyst Medical Clinic Pa 29 E Main St Waconia MN 55387-1114 Ph: (952) 442-7015 | Catalyst Medical Clinic Pa 204 Lewis Ave S Ste 201 Watertown MN 55388-4502 Ph: (952) 955-1963 |
| NPI Number | 1457456691 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 03/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457456691 | NPI | - | NPPES |
| 860567000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 1540 (Minnesota) | Primary |