Kendall Dewayne Ricklefs D.O.

NPI 1780887547 - Internal Medicine - 207R00000X

NPI Details
NPI 1780887547
Gender Male
Enumeration Date 06/08/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
MINNEAPOLIS MN, 55454-1450, US
Phone (612) 672-2563
Business Location
815 13TH AVE SE
MINNEAPOLIS MN, 55414-1471, US
Taxonomy Code 207R00000X
License State Minnesota
License Number 48744
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According to our database, Kendall Dewayne Ricklefs D.O. NPI is 1780887547, taxonomy code is 207R00000X and license number is 48744, license state is located at Minnesota. Kendall Dewayne Ricklefs D.O. physically located at 2450 Riverside Ave, Minneapolis MN, 55454-1450. NPI Number Kendall Dewayne Ricklefs D.O. has the Individual type.

1780887547 NPI number is provided on an as is basis without warranty of any kind. 1780887547 is maintained by the National Plan & Provider Enumeration System. The contents of Kendall Dewayne Ricklefs D.O. are for informational purposes only.