Organization
IF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON CAMPBELL (OWNER)
(612) 839-8350
Entity
Organization
Contact information
Practice address
6770 STILLWATER BLVD N STE 200, STILLWATER, MN 55082-5438
(612) 839-8350
Mailing address
6770 STILLWATER BLVD N STE 200, STILLWATER, MN 55082-5438
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/24/2025
Last updated
11/24/2025
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