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Organization

STAND UP MID AMERICA MRI, P.A.

Active
Other names
SUMA MRI, P.A.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WAYNE E DAHL D.C. (PRESIDENT OWNER)
(763) 521-5000
Entity
Organization

Contact information

Practice address
604 LILAC DR N, SUITE 100, GOLDEN VALLEY, MN 55422-4610
(753) 521-5000
(763) 521-2000
Mailing address
604 LILAC DR N, SUITE 100, GOLDEN VALLEY, MN 55422-4610
(753) 521-5000
(763) 521-2000

Taxonomy

Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
261QR0200X
Radiology Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051128500
MN
Enumeration date
03/01/2007
Last updated
07/25/2008
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