Organization
PROSTEP
Active
Organization
PROSTEP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN THERESA PINEO (COTA/L)
(612) 267-0862
Entity
Organization
Contact information
Practice address
7505 COUNTRY CLUB DR, GOLDEN VALLEY, MN 55427-4501
(763) 450-6902
Mailing address
7505 COUNTRY CLUB DR, GOLDEN VALLEY, MN 55427-4501
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
201816
MN
Other
Enumeration date
11/20/2013
Last updated
11/20/2013
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