Organization
AFFINITY MEDICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATIE FOKKEN (VICE PRESIDENT)
(763) 551-1344
Entity
Organization
Contact information
Practice address
9446 36TH AVE N, NEW HOPE, MN 55427-1718
(763) 551-1344
(763) 551-1544
Mailing address
9446 36TH AVE N, NEW HOPE, MN 55427-1718
(763) 551-1344
(763) 551-1544
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4505
MN
111N00000X
Chiropractor
4547
MN
208100000X
Physical Medicine & Rehabilitation Physician
8833
MN
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
44760
MN
363AM0700X
Medical Physician Assistant
9656
MN
Other
Enumeration date
02/08/2011
Last updated
01/17/2013
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