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Organization
SILVER LAKE CLINIC
Active
Organization
SILVER LAKE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK BORAN (CHIEF FINANCIAL OFFICER, VP FINANCE)
(763) 520-5048
Entity
Organization
Contact information
Practice address
2600 39TH AVE NE, ST ANTHONY, MN 55421-4372
(612) 706-2900
(612) 706-2901
Mailing address
2600 39TH AVE NE, ST ANTHONY, MN 55421-4372
(612) 706-2900
(612) 706-2901
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/23/2006
Last updated
08/22/2020
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