# ALLERGY, ASTHMA AND IMMUNOLOGY CLINIC, P.A.

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

## Provider details

- **NPI number:** 1891729737
- **Authorized official:** AUDREY D CECKO (OFFICE MANAGER)
- **Authorized official phone:** (651) 765-9800

## Contact information

- **Practice address:** 4625 CHURCHILL ST, SUITE 211, SHOREVIEW, MN 55126-5868
- **Practice address phone:** (651) 765-9800
- **Practice address fax:** (651) 765-9801
- **Mailing address:** 4625 CHURCHILL ST, SUITE 211, SHOREVIEW, MN 55126-5868
- **Mailing address phone:** (651) 765-9800
- **Mailing address fax:** (651) 765-9801

## Taxonomy

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

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 11/27/2007