Organization
TARGET CLINIC MINNESOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL TEUFER (CREDENTIALING CONTACT)
(612) 761-6395
Entity
Organization
Contact information
Practice address
1650 NEW BRIGHTON BLVD, MINNEAPOLIS, MN 55413-1643
(612) 781-7033
Mailing address
PO BOX 9066, BELFAST, ME 04915-9066
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R16914-2
MN
Other
Enumeration date
09/18/2013
Last updated
09/18/2013
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