247200000X
Vadnais Heights, MN
Specialty
247200000X
Credential
LAT, OTC
NPI
1174110043
3580 Arcade St, Vadnais Heights, MN 55127
(651) 968-5662Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 247200000x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 247200000X