Organization
THANACARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN HALLEN (VICE PRESIDENT)
(763) 360-5135
Entity
Organization
Contact information
Practice address
3621 ABBOTT AVE S, MINNEAPOLIS, MN 55410-1033
(855) 698-4262
Mailing address
3621 ABBOTT AVE S, MINNEAPOLIS, MN 55410-1033
(855) 698-4262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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