Organization
TCOH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE K BAVERTY (CLINIC ADMINISTRATOR)
(651) 224-8264
Entity
Organization
Contact information
Practice address
2520 PILOT KNOB RD, MENDOTA HEIGHTS, MN 55120-1137
(651) 224-8264
Mailing address
2520 PILOT KNOB RD, MENDOTA HEIGHTS, MN 55120-1137
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2006
Last updated
10/20/2010
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