Organization
SEBANDY PCA SERVICES, LLC
Active
Other names
Renae Cooley
Organization subpart
No
Provider details
NPI number
Authorized official
RENAE ANN COOLEY (OWNER/QP/AA)
(651) 383-6764
Entity
Organization
Contact information
Practice address
2548 LISA LN NE, ROCHESTER, MN 55906-6209
(651) 383-6764
(507) 281-1162
Mailing address
2548 LISA LN NE, ROCHESTER, MN 55906-6209
(651) 383-6764
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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