Individual
MARK KOLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 W 66TH ST STE 375, EDINA, MN 55435-2168
(952) 926-7374
Mailing address
3400 W 66TH ST STE 375, EDINA, MN 55435-2168
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
31306
MN
Other
Enumeration date
01/02/2008
Last updated
01/02/2008
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