Individual
LEIF PER-ALDEN SUNDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4786 BANNING AVE, WHITE BEAR LAKE, MN 55110-3264
(651) 426-6402
(651) 429-3402
Mailing address
2025 SLOAN PL STE 35, SAINT PAUL, MN 55117-2092
(651) 772-1572
(651) 772-1889
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13719
MN
Other
Enumeration date
03/14/2021
Last updated
07/12/2021
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