Organization
MINNESOTA HEAD AND NECK PAIN CLINIC, PA
Active
Organization
MINNESOTA HEAD AND NECK PAIN CLINIC, PA
Active
Other names
Minnesota Head & Neck Pain Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TIA A REICHERT (CHRO/CLINIC ADMIN)
(763) 577-2484
Entity
Organization
Contact information
Practice address
622 ROOSEVELT RD, SAINT CLOUD, MN 56301-6153
(763) 577-2484
(763) 577-1375
Mailing address
3475 PLYMOUTH BLVD STE 200, PLYMOUTH, MN 55447-1539
(763) 577-2484
(763) 577-1375
Taxonomy
Speciality
Code
Description
License number
State
1223X2210X
Orofacial Pain Dentistry
Primary
—
—
174400000X
Specialist
—
—
Other
Enumeration date
02/19/2018
Last updated
07/17/2024
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