| Good Clinic Mn Pllc | |
|
4712 Excelsior Blvd St Louis Park MN 55416-3008 | |
| (844) 383-8689 | |
| Not Available |
| Full Name | Good Clinic Mn Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4712 Excelsior Blvd, St Louis Park, Minnesota |
| Authorized Official Name and Position | Kevin Lee Smith (CHIEF NURSE PRACTITIONER OFFICER) |
| Authorized Official Contact | 7636395327 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Clinic Mn Pllc 1660 Highway 100 S Ste 432 St Louis Park MN 55416-1533 Ph: () - | Good Clinic Mn Pllc 4712 Excelsior Blvd St Louis Park MN 55416-3008 Ph: (844) 383-8689 |
| NPI Number | 1003423252 |
|---|---|
| Provider Enumeration Date | 09/30/2020 |
| Last Update Date | 01/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003423252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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