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Individual

JUSTIN M RICHTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(612) 863-4000
Mailing address
12321 LEVER ST NE, BLAINE, MN 55449-6643
(507) 923-6095

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R2161060
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
2407
MN

Other

Enumeration date
09/25/2019
Last updated
12/04/2019
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