Organization
CATALYST MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT M JENSEN MD (PRESIDENT/OWNER)
(952) 955-1963
Entity
Organization
Contact information
Practice address
204 LEWIS AVE S STE 201, WATERTOWN, MN 55388-4502
(952) 955-1963
(952) 955-1965
Mailing address
29 E MAIN ST, WACONIA, MN 55387-1114
(952) 442-7015
(952) 442-7016
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
1540
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
860567000
—
MN
Enumeration date
09/13/2006
Last updated
03/27/2018
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