Individual
ELIZABETH ANNE RADKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
Mailing address
13599 QUENTIN AVE S, SAVAGE, MN 55378-1814
(612) 220-1891
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1128
MN
Other
Enumeration date
05/28/2008
Last updated
07/13/2009
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