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Individual

KEITH ROBERT UZPEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-S

Contact information

Practice address
2211 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1350
(999) 999-9999
Mailing address
3473 SAVANNAH AVE, WHITE BEAR LAKE, MN 55110-4580

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
363A00000X
Physician Assistant
390200000X
Student in an Organized Health Care Education/Training Program
Primary
MN

Other

Enumeration date
02/07/2007
Last updated
05/20/2024
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