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Organization
SOUTHSIDE MEDICAL CLINIC AT THE ADLER CENTER
Active
Organization
SOUTHSIDE MEDICAL CLINIC AT THE ADLER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM HENRY TENDLE JR. (EXECUTIVE DIRECTOR)
(612) 821-2800
Entity
Organization
Contact information
Practice address
416 E HENNEPIN AVE, MINNEAPOLIS, MN 55414-1006
(612) 822-9030
Mailing address
4243 4TH AVE S, MINNEAPOLIS, MN 55409-2113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/28/2012
Last updated
04/30/2014
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