Organization
SOUTHSIDE MEDICAL CLINIC AT THE ADLER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM HENRY TENDLE JR. (EXECUTIVE DIRECTOR)
(612) 821-2800
Entity
Organization
Contact information
Practice address
416 E HENNEPIN AVE, MINNEAPOLIS, MN 55414-1006
(612) 822-9030
Mailing address
4243 4TH AVE S, MINNEAPOLIS, MN 55409-2113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/28/2012
Last updated
04/30/2014
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