Organization
ADVANCED SPINE AND PAIN CLINICS OF MINNESOTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW GERALD THORSON M.D. (PRESIDENT/OWNER)
(612) 207-7463
Entity
Organization
Contact information
Practice address
2801 WAYZATA BLVD, MINNEAPOLIS, MN 55405-2125
(612) 207-7463
(612) 315-4473
Mailing address
2801 WAYZATA BLVD, MINNEAPOLIS, MN 55405-2125
(612) 207-7463
(952) 831-0276
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P0004X
Spinal Cord Injury Medicine Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
530615900
—
MN
Enumeration date
05/24/2012
Last updated
02/07/2022
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