Organization
MIDWEST TMS LLC
Active
Parent organization
MIDWEST WELLNESS INSTITUTE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIDWEST WELLNESS INSTITUTE LLC
Authorized official
CLAY JOSEPH PAVLIS MD (OWNER)
(605) 864-1795
Entity
Organization
Contact information
Practice address
1309 OAK AVE STE 207, WACONIA, MN 55387-1080
(952) 442-3828
Mailing address
1309 OAK AVE STE 207, WACONIA, MN 55387-1080
(952) 442-3828
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
47358
MN
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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