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Organization

MINNESOTA HEAD AND NECK PAIN CLINIC, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIA A REICHERT (CHRO/CLINIC ADMINISTRATOR)
(763) 577-2484
Entity
Organization

Contact information

Practice address
3475 PLYMOUTH BLVD, SUITE 200, PLYMOUTH, MN 55447-1499
(763) 577-2484
(763) 577-1375
Mailing address
3475 PLYMOUTH BLVD, SUITE 200, PLYMOUTH, MN 55447-1499
(763) 577-2484
(763) 577-1375

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
06/29/2015
Last updated
07/17/2024
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