Organization
TWILIGHT TATTOO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI LOUSIE WALLIN (MANAGER)
(612) 214-1311
Entity
Organization
Contact information
Practice address
3054 BLOOMINGTON AVE, MINNEAPOLIS, MN 55407-1716
(612) 722-2233
Mailing address
3054 BLOOMINGTON AVE, MINNEAPOLIS, MN 55407-1716
(612) 722-2233
Taxonomy
Speciality
Code
Description
License number
State
246ZA2600X
Medical Art Specialist/Technologist
Primary
—
—
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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