Individual
DR. KEITH A MOENCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
295 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 495-6200
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
52609
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2009
Last updated
12/02/2024
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