Organization
CORBAN HEALTH CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE MARIE CARLEEN M.D. (SOLE OWNER/MANAGER)
(612) 644-9047
Entity
Organization
Contact information
Practice address
5141 36TH AVE S, MINNEAPOLIS, MN 55417-1518
(612) 644-9047
Mailing address
5141 36TH AVE S, MINNEAPOLIS, MN 55417-1518
(612) 644-9047
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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