Tubman

NPI 1295866911 - Clinic/Center - 261QR0405X

NPI Details
NPI 1295866911
Enumeration Date 03/07/2007
Last Updated 11/12/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name BEVERLY BEVERLY
Position EXECUTIVE DIRECTOR
Phone (612) 870-2444
Fax (612) 870-2428
Practice Location
4432 CHICAGO AVE S
MINNEAPOLIS MN, 55407-3519, US
Phone (612) 870-2444
Fax (612) 870-2428
Business Location
4432 CHICAGO AVE S
MINNEAPOLIS MN, 55407-3519, US
Phone (612) 870-2444
Fax (612) 870-2428
Toxanomy
Taxonomy Code 261QR0405X
License State Minnesota
License Number 800488-3-CDT
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According to our database, Tubman NPI is 1295866911, taxonomy code is 261QR0405X and license number is 800488-3-CDT, license state is located at Minnesota. Tubman physically located at 4432 Chicago Ave S, Minneapolis MN, 55407-3519. NPI Number 1033115704 has the healthcare provider type.

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1295866911 NPI number is provided on an as is basis without warranty of any kind. 1295866911 is maintained by the National Plan & Provider Enumeration System. The contents of Tubman are for informational purposes only.