Organization
BRG GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENELOPE SMITH (PRESIDENT)
(952) 820-5193
Entity
Organization
Contact information
Practice address
550 MAIN ST, NEW BRIGHTON, MN 55112-3271
(952) 820-5193
Mailing address
7809 SOUTHTOWN CTR # 112, BLOOMINGTON, MN 55431-1324
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
MN
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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