Organization
HOMEOPATHIC MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB I MIRMAN MD (PRESIDENT)
(952) 933-8900
Entity
Organization
Contact information
Practice address
4201 EXCELSIOR BLVD, MINNEAPOLIS, MN 55416-4728
(952) 933-8900
(952) 945-9536
Mailing address
4201 EXCELSIOR BLVD, MINNEAPOLIS, MN 55416-4728
(952) 933-8900
(952) 945-9536
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2002688
—
MN
Enumeration date
10/21/2008
Last updated
10/21/2008
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