# NEW LEAF MEDICAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316369911
- **Authorized official:** SANDRA KAY WIITA MD (SOLE SHAREHOLDER)
- **Authorized official phone:** (952) 777-2355

## Contact information

- **Practice address:** 3622 COUNTY ROAD 101 S, WAYZATA, MN 55391-3424
- **Practice address phone:** (952) 777-2355
- **Mailing address:** 3622 COUNTY ROAD 101 S, WAYZATA, MN 55391-3424
- **Mailing address phone:** (952) 777-2355

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 42376 | MN | Yes |

## Other

- **Enumeration date:** 01/16/2014
- **Last updated:** 01/16/2014