Organization
WEST CENTRAL NEUROLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE JOHN JEDLICKA MD (PRESIDENT)
(907) 290-6355
Entity
Organization
Contact information
Practice address
11521 312TH AVE, PRINCETON, MN 55371-3423
(763) 389-4910
Mailing address
PO BOX 110614, ANCHORAGE, AK 99511-0614
(763) 389-4910
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
33547
MN
Other
Enumeration date
11/20/2008
Last updated
11/19/2018
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