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Organization

PARKSIDE HEALTH CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BEVERLY BUCKNER (OWNER/DIRECTOR)
(952) 303-3104
Entity
Organization

Contact information

Practice address
8609 LYNDALE AVE S, SUITE 105B, BLOOMINGTON, MN 55420-2754
(952) 303-3104
Mailing address
8609 LYNDALE AVE S, SUITE 105B, BLOOMINGTON, MN 55420-2754
(952) 303-3104

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MN

Other

Enumeration date
07/19/2007
Last updated
07/19/2007
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