Individual
MISS JOY MINDEN MATTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
457 STONEWOOD LN, BURNSVILLE, MN 55306-2503
(612) 227-6569
Mailing address
457 STONEWOOD LN, BURNSVILLE, MN 55306-2503
(612) 227-6569
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L650036
MN
Other
Enumeration date
02/06/2011
Last updated
02/06/2011
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