Individual
JONATHAN R RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3007 HARBOR LN N, PARK NICOLLET CLINIC PLYMOUTH, PLYMOUTH, MN 55447
(952) 993-8900
(952) 993-8955
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40421
MN
Other
Enumeration date
12/14/2005
Last updated
03/11/2021
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