Organization
HEALTHEAST OUTPATIENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG DAVENPORT (CFO)
(651) 232-2250
Entity
Organization
Contact information
Practice address
1700 UNIVERSITY AVE W, 7TH FLOOR, SAINT PAUL, MN 55104-3727
(651) 232-7000
(651) 232-1187
Mailing address
1700 UNIVERSITY AVE W, 7TH FLOOR, SAINT PAUL, MN 55104-3727
(651) 232-7000
(651) 232-1187
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/08/2012
Last updated
05/20/2015
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