Individual
LEAH C MATHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 JACKSON STREET, MC 11109E, ST. PAUL, MN 55101-2502
(651) 254-3456
(651) 254-9673
Mailing address
PO BOX 1309, 8170 33RD AVE S - MAIL STOP 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 254-3456
(651) 254-9673
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
11598
MN
363AM0700X
Medical Physician Assistant
2096
MN
Other
Enumeration date
07/10/2014
Last updated
10/26/2015
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