| Spectrum Development Center Service Corporation | |
|
14540 Pennock Ave Ste 102 Apple Valley MN 55124-7443 | |
| (612) 366-4807 | |
| Not Available |
| Full Name | Spectrum Development Center Service Corporation |
|---|---|
| Speciality | Clinic/center |
| Location | 14540 Pennock Ave Ste 102, Apple Valley, Minnesota |
| Authorized Official Name and Position | Ahmedkhadar Warsame (OWNER) |
| Authorized Official Contact | 6123664807 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Development Center Service Corporation 14540 Pennock Ave Ste 102 Apple Valley MN 55124-7443 | Spectrum Development Center Service Corporation 14540 Pennock Ave Ste 102 Apple Valley MN 55124-7443 Ph: (612) 366-4807 |
| NPI Number | 1134936230 |
|---|---|
| Provider Enumeration Date | 12/12/2024 |
| Last Update Date | 12/12/2024 |
| Certification Date | 12/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134936230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
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