Organization
REALIEF MEDICAL P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HALEY (OPERATIONS MANAGER)
(952) 456-6160
Entity
Organization
Contact information
Practice address
1660 HIGHWAY 100 S, SUITE 229, ST LOUIS PARK, MN 55416-1529
(952) 456-6160
(952) 456-6184
Mailing address
1660 HIGHWAY 100 S, SUITE 229, ST LOUIS PARK, MN 55416-1529
(952) 456-6160
(952) 456-6184
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
24538
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C09271
MEDICARE PTAN
MN
Enumeration date
12/19/2012
Last updated
09/10/2013
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