Organization
HEALTHY MILES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAMON KENTON (OWNER)
(612) 242-9517
Entity
Organization
Contact information
Practice address
4142 SHORELINE DR, SPRING PARK, MN 55384-9629
(866) 305-0622
Mailing address
4142 SHORELINE DR, SPRING PARK, MN 55384-9629
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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