Individual
SIMON LOUIS MAZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MSPAS
Contact information
Practice address
1415 LILAC DR N STE 190, MINNEAPOLIS, MN 55422-4544
(763) 267-8701
Mailing address
1415 LILAC DR N STE 190, MINNEAPOLIS, MN 55422-4544
(763) 297-8701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/05/2021
Last updated
01/11/2023
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