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Organization
ADVANCED SPINE AND PAIN CLINICS OF MINNESOTA LLC
Active
Organization
ADVANCED SPINE AND PAIN CLINICS OF MINNESOTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW GERALD THORSON M.D. (PRESIDENT/OWNER)
(612) 207-7463
Entity
Organization
Contact information
Practice address
2801 WAYZATA BLVD, MINNEAPOLIS, MN 55405-2125
(612) 207-7463
(612) 315-4473
Mailing address
2801 WAYZATA BLVD, MINNEAPOLIS, MN 55405-2125
(612) 207-7463
(952) 831-0276
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P0004X
Spinal Cord Injury Medicine Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
530615900
—
MN
Enumeration date
05/24/2012
Last updated
02/07/2022
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