Organization
KEMET CIRCLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAVONNE MOORE RNC, CNM, IBCLC (PRESIDENT)
(612) 850-0016
Entity
Organization
Contact information
Practice address
1805 GIRARD AVE N, MINNEAPOLIS, MN 55411-3104
(612) 850-0016
Mailing address
1805 GIRARD AVE N, MINNEAPOLIS, MN 55411-3104
(612) 850-0016
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
R1138272
MN
Other
Enumeration date
02/01/2010
Last updated
02/01/2010
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