Organization
TLC
Active
Parent organization
THE LYMPHEDEMA CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE LYMPHEDEMA CENTER
Authorized official
COLLEEN MARTENS ENDRIZZI (CEO)
(612) 554-5005
Entity
Organization
Contact information
Practice address
5641 AUDREY AVE, INVER GROVE HEIGHTS, MN 55077-1812
(612) 554-5005
Mailing address
6311 WAYZATA BLVD, SUITE 310, MINNEAPOLIS, MN 55416-1209
(952) 545-0200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
101152
MN
235Z00000X
Speech-Language Pathologist
Primary
5742
MN
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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