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Organization
ROBBINSDALE CLINIC, P.A.
Active
Organization
ROBBINSDALE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE A JOHNSON (OFFICE MANAGER)
(763) 533-2534
Entity
Organization
Contact information
Practice address
3819 W BROADWAY AVE, ROBBINSDALE, MN 55422-2207
(763) 533-2534
Mailing address
PO BOX 22220, ROBBINSDALE, MN 55422-0220
(763) 533-2534
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
684
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075310600
—
MN
01
—
24D0402400
CLIA
MN
Enumeration date
10/26/2006
Last updated
03/02/2010
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