Organization
PRIMARY CARE & REHABILITATION CLINICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEON B FRID D.C. (PRESIDENT)
(952) 933-8900
Entity
Organization
Contact information
Practice address
3015 UTAH AVE S, ST LOUIS PARK, MN 55426-3671
(952) 933-8900
(952) 945-9536
Mailing address
3015 UTAH AVE S, ST LOUIS PARK, MN 55426-3671
(952) 933-8900
(952) 945-9536
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2M391TE
BCBS MD PROVIDER #
MN
01
—
3C060TE
BCBS D.C. PROV #
MN
01
—
8B610TE
BCBS PT PROVIDER #
MN
Enumeration date
06/22/2005
Last updated
08/22/2020
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