Organization
CLIPDIFFERENT, GBC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE MCMULLEN (PRESIDENT)
(612) 396-0888
Entity
Organization
Contact information
Practice address
11024 CAVELL CIR, BLOOMINGTON, MN 55438-2284
(612) 554-8799
Mailing address
PO BOX 278, LONG LAKE, MN 55356-0278
(612) 396-0888
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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