Organization
HIAWATHA CLINIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS HUDO O MIRE (MANAGER)
(651) 308-8842
Entity
Organization
Contact information
Practice address
2275 SNELLING AVE N APT 309, ROSEVILLE, MN 55113-4285
(651) 308-8842
(612) 225-6758
Mailing address
2275 SNELLING AVE N APT 309, ROSEVILLE, MN 55113-4285
(651) 308-8842
(612) 225-6758
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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