Individual
KRISTEN R RADTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3850 PARK NICOLLET BLVD, PARK NICOLLET CLINIC SLP, ST LOUIS PARK, MN 55416-2527
(952) 993-3123
Mailing address
6465 WAYZATA BLVD, STE 315, ST LOUIS PARK, MN 55426-1728
(952) 993-6450
(952) 993-0300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
43772
MN
Other
Enumeration date
12/08/2005
Last updated
06/29/2012
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