Organization
GOULD ENTERPRISE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOLOMON M GOULD (OWNER)
(651) 739-5173
Entity
Organization
Contact information
Practice address
1995 BURNS AVE STE B, SAINT PAUL, MN 55119
(651) 739-5173
(651) 739-8907
Mailing address
1995 BURNS AVE STE B, SAINT PAUL, MN 55119-4906
(651) 739-5173
(651) 739-8907
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518232149
TYPE I NPI
MN
01
—
1750888335
TYPE II NPI
—
01
—
3415
MN LICENSE
MN
Enumeration date
04/10/2018
Last updated
06/26/2018
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