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Organization

GOOD CLINIC MN PLLC

Active
Other names
The Good Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN LEE SMITH DNP (CHIEF NURSE PRACTITIONER OFFICER)
(763) 639-5327
Entity
Organization

Contact information

Practice address
4712 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416-3008
(844) 383-8689
Mailing address
1660 HIGHWAY 100 S STE 432, ST LOUIS PARK, MN 55416-1533

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Enumeration date
09/30/2020
Last updated
01/14/2022
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