Organization
CRYSTAL TWYNHAM MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRYSTAL ULANI TWYNHAM MD (OWNER)
(931) 237-2265
Entity
Organization
Contact information
Practice address
15552 68TH PL N, MAPLE GROVE, MN 55311-3291
(931) 237-2265
(612) 594-8998
Mailing address
15552 68TH PL N, MAPLE GROVE, MN 55311-3291
(931) 237-2265
(612) 594-8998
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
39691
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
514517100
—
MN
Enumeration date
01/15/2011
Last updated
06/01/2015
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