Organization
GOOD CLINIC MN PLLC
Active
Organization
GOOD CLINIC MN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA HAFNER-FOGARTY MD (AUTHORIZED OFFICIAL)
(612) 284-8206
Entity
Organization
Contact information
Practice address
307 1ST AVENUE, MINNEAPOLIS, MN 55413-0000
(952) 653-2525
(952) 653-2540
Mailing address
307 1ST AVENUE, MINNEAPOLIS, MN 55413
(952) 653-2525
(952) 653-2540
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
03/04/2021
Last updated
03/04/2021
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