Organization
OVO OBS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LOBANOFF MD (MEDICAL DIRECTOR)
(877) 686-3937
Entity
Organization
Contact information
Practice address
6099 WAYZATA BLVD, ST LOUIS PARK, MN 55416
(877) 686-3937
Mailing address
6099 WAYZATA BLVD, ST LOUIS PARK, MN 55416
(877) 686-3937
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
—
Other
Enumeration date
09/20/2021
Last updated
02/02/2024
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