Organization
ILBNC, P.A.
Active
Organization
ILBNC, P.A.
Active
Other names
Institute for Low Back & Neck Care
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK WILFRED JUSTIN R.N. (DIRECTOR OF SURGERY CENTER)
(952) 814-6600
Entity
Organization
Contact information
Practice address
15700 37TH AVE N, SUITE 210, PLYMOUTH, MN 55446-3399
(952) 814-6600
Mailing address
3001 METRO DR, SUITE 330, BLOOMINGTON, MN 55425-4506
(952) 814-6600
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
24C0001052
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310032400
—
MN
Enumeration date
06/27/2006
Last updated
01/07/2015
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