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Organization
TLC
Active
Organization
TLC
Active
Parent organization
THE LYMPHEDEMA CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE LYMPHEDEMA CENTER
Authorized official
COLLEEN MARTENS ENDRIZZI (CEO)
(612) 554-5005
Entity
Organization
Contact information
Practice address
5641 AUDREY AVE, INVER GROVE HEIGHTS, MN 55077-1812
(612) 554-5005
Mailing address
6311 WAYZATA BLVD, SUITE 310, MINNEAPOLIS, MN 55416-1209
(952) 545-0200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
101152
MN
235Z00000X
Speech-Language Pathologist
Primary
5742
MN
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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