Individual
MRS. MELISSA JILL LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 232-7599
Mailing address
4091 WILD GOOSE LN, WHITE BEAR LAKE, MN 55110-7639
(651) 232-7599
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
1674
MN
Other
Enumeration date
06/29/2015
Last updated
06/29/2015
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