Individual
TEILO LINCOLN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HOME MAKER
Contact information
Practice address
1595 68TH AVE NE, MINNEAPOLIS, MN 55432-4714
(763) 732-9685
Mailing address
5775 WAYZATA BLVD, SUITE 700, ST LOUIS PARK, MN 55416-1222
(763) 732-9685
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
348032
CLASS A PROFESSIONAL HOME HEALTH AGENCY
MN
Enumeration date
08/28/2010
Last updated
08/28/2010
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