Organization
PALLIATIVE PROVIDERS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS V SOUKUP DO (PHYSICIAN)
(651) 247-4727
Entity
Organization
Contact information
Practice address
4707 HIGHWAY 61 N STE 116, WHITE BEAR LAKE, MN 55110-3227
(651) 247-4727
Mailing address
4707 HIGHWAY 61 N STE 116, WHITE BEAR LAKE, MN 55110-3227
(651) 247-4727
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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