Organization
MBH-MN MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BUD LILE MD (OWNER/MEDICAL DIRECTOR)
(612) 232-7558
Entity
Organization
Contact information
Practice address
550 MAIN ST STE 260, NEW BRIGHTON, MN 55112-3273
(612) 326-7558
Mailing address
550 MAIN ST # 190, NEW BRIGHTON, MN 55112-3271
(612) 454-2046
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/30/2018
Last updated
08/30/2018
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