Organization
KNEEWELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KERRY GILDERMAN (MANAGER)
(612) 213-2879
Entity
Organization
Contact information
Practice address
4175 ARBOR LN, EAGAN, MN 55122-2869
(612) 213-2879
(612) 254-8245
Mailing address
4175 ARBOR LN, EAGAN, MN 55122-2869
(612) 213-2879
(612) 254-8245
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4786380
DEPARTMENT OF REVENUE
MN
Enumeration date
01/18/2019
Last updated
01/18/2019
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