Individual
MRS. SAMANTHA ANN RENFROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(612) 874-1292
Mailing address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(727) 254-8884
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14613
MN
Other
Enumeration date
01/04/2023
Last updated
10/04/2023
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