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Individual

GEORGIA UNDERWOOD-WRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
300 LAKE DR E, CHANHASSEN, MN 55317-9302
(952) 993-4300
Mailing address
6465 WAYZATA BLVD, STE 315, MINNEAPOLIS, MN 55426-1728

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
983164900
MN
Enumeration date
01/11/2006
Last updated
10/04/2018
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