Organization
UNIVERSITY OF MINNESOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY JORDAN (OFFICIAL)
(612) 625-8284
Entity
Organization
Contact information
Practice address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
(612) 625-4618
Mailing address
3043 INGLEWOOD AVE S, APT #5, SAINT LOUIS PARK, MN 55416-4123
(949) 633-5490
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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