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Organization

EDDICTION MEDICINE PLLC

Active
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Organization

EDDICTION MEDICINE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CORI MYER (OFFICE STAFF)
(612) 393-1212
Entity
Organization

Contact information

Practice address
12018 285TH STREET, LINDSTROM, MN 55045
(612) 393-1212
(651) 400-3892
Mailing address
PO BOX 833, LINDSTROM, MN 55045-0833
(612) 393-1212
(651) 257-9422

Taxonomy

Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1932488608
MN
Enumeration date
10/09/2020
Last updated
05/04/2021
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