Organization
STRONG TOWER HEALTH FAMILY CLINIC
Active
Parent organization
STRONG TOWER HEALTH
Other names
Strong Tower Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
STRONG TOWER HEALTH
Authorized official
LATONYA J WHITLEY DNP (PRINCIPAL EXECUTIVE DIRECTOR)
(612) 701-4301
Entity
Organization
Contact information
Practice address
1686 SUBURBAN AVE, ST PAUL, MN 55106-5510
(612) 701-4301
(651) 330-1802
Mailing address
PO BOX 600418, SAINT PAUL, MN 55106-0007
(612) 701-4301
(651) 330-1802
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6186078
MN TAX IDENTIFICATION
MN
Enumeration date
04/25/2019
Last updated
04/25/2019
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