Jesse L Goembel PA-C

NPI 1356486963 - Physician Assistant - 363A00000X

NPI Details
NPI 1356486963
Gender Male
Enumeration Date 02/21/2007
Last Updated 01/26/2009
Entity Type Individual
Active Over 9 years ago
Practice Location
550 OSBORNE RD NE
FRIDLEY MN, 55432-2718, US
Phone (763) 236-5000
Fax (763) 236-3516
Business Location
550 OSBORNE RD NE
FRIDLEY MN, 55432-2718, US
Phone (763) 236-5000
Fax (763) 236-3516
Toxanomy
Taxonomy Code 363A00000X
License State South Dakota
License Number 0643
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According to our database, Mr. Jesse L Goembel PA-C NPI is 1356486963, taxonomy code is 363A00000X and license number is 0643, license state is located at South Dakota. Jesse L Goembel PA-C physically located at 550 Osborne Rd Ne, Fridley MN, 55432-2718. NPI Number Jesse L Goembel PA-C has the Individual type.

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1356486963 NPI number is provided on an as is basis without warranty of any kind. 1356486963 is maintained by the National Plan & Provider Enumeration System. The contents of Jesse L Goembel PA-C are for informational purposes only.