Individual
RISA BACHE-WIIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5109 36TH AVE N, CRYSTAL, MN 55422-2007
(763) 587-7900
(763) 587-7989
Mailing address
9201 W BROADWAY AVE STE 601, BROOKLYN PARK, MN 55445-1924
(763) 587-7900
(763) 587-7066
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
65974
MN
208D00000X
General Practice Physician
65974
MN
Other
Enumeration date
03/31/2018
Last updated
11/07/2022
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