Organization
OPTAGE PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON KLEFSAAS (EXECUTIVE DIRECTOR OF OPERATIONS)
(651) 631-6145
Entity
Organization
Contact information
Practice address
2845 HAMLINE AVE N, ROSEVILLE, MN 55113-7127
(651) 631-6100
(651) 631-6343
Mailing address
2845 HAMLINE AVE N, ROSEVILLE, MN 55113-7127
(651) 631-6100
(651) 631-6343
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/17/2011
Last updated
09/22/2011
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