Organization
BLOSSOM WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELVIS TAMBI STARLLONE CNP (OWNER)
(651) 410-7955
Entity
Organization
Contact information
Practice address
625 HAYWARD AVE N, OAKDALE, MN 55128-7127
(651) 410-7955
Mailing address
625 HAYWARD AVE N, OAKDALE, MN 55128-7127
(651) 410-7955
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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