Individual
MICHAEL RUSSELL NEUTKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
480 OSBORNE RD NE, FRIDLEY, MN 55432-2773
(763) 785-4500
Mailing address
480 OSBORNE RD NE, FRIDLEY, MN 55432-2773
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MN
Other
Enumeration date
07/08/2013
Last updated
10/04/2017
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