| Premise Health Of Minnesota Medical P C | |
|
13998 Maple Knoll Way Ste 101 Maple Grove MN 55369-7004 | |
| (651) 683-2434 | |
| Not Available |
| Full Name | Premise Health Of Minnesota Medical P C |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 13998 Maple Knoll Way Ste 101, Maple Grove, Minnesota |
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Minnesota Medical P C 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health Of Minnesota Medical P C 13998 Maple Knoll Way Ste 101 Maple Grove MN 55369-7004 Ph: (651) 683-2434 |
| NPI Number | 1528780376 |
|---|---|
| Provider Enumeration Date | 09/16/2022 |
| Last Update Date | 09/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528780376 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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