Organization
NUCLEUS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE LYNN HENDRICKSON CEO (CHEIF EXECUTIVE OFFICER)
(763) 755-5300
Entity
Organization
Contact information
Practice address
1323 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-5362
(763) 755-5300
(763) 755-5301
Mailing address
1323 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-5362
(763) 755-5300
(763) 755-5301
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
02/04/2008
Last updated
02/04/2008
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