Organization
TATTOO REMOVAL SHOP
Active
Parent organization
TATTOO REMOVAL SHOP
Other names
Lion Thorn Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
TATTOO REMOVAL SHOP
Authorized official
MICHAEL TOWEY M.D. (OWNER/OPERATOR)
(952) 922-9462
Entity
Organization
Contact information
Practice address
7373 FRANCE AVE S, SUITE 504, EDINA, MN 55435-4549
(952) 922-9462
(952) 922-8914
Mailing address
7373 FRANCE AVE S, SUITE 504, EDINA, MN 55435-4549
(952) 922-9462
(952) 922-8914
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
32775
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276000200
—
MN
Enumeration date
02/28/2017
Last updated
02/28/2017
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