Individual
CLAY MATTHEW ROMANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11855 ULYSSES ST NE STE 120, BLAINE, MN 55434-3948
(763) 581-2273
Mailing address
4181 108TH AVE NE, BLAINE, MN 55449-7439
(763) 581-5952
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
13641
MN
Other
Enumeration date
04/21/2020
Last updated
03/21/2023
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