| Health Source Of Woodbury Pa | |
|
7060 Valley Creek Plz Ste 121 Woodbury MN 55125-2269 | |
| (651) 735-8646 | |
| Not Available |
| Full Name | Health Source Of Woodbury Pa |
|---|---|
| Speciality | Clinic/center |
| Location | 7060 Valley Creek Plz Ste 121, Woodbury, Minnesota |
| Authorized Official Name and Position | Jeffrey J. Wisdo (OWNER) |
| Authorized Official Contact | 6517358646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Source Of Woodbury Pa 7060 Valley Creek Plz Ste 121 Woodbury MN 55125-2269 Ph: (651) 735-8646 | Health Source Of Woodbury Pa 7060 Valley Creek Plz Ste 121 Woodbury MN 55125-2269 Ph: (651) 735-8646 |
| NPI Number | 1447401971 |
|---|---|
| Provider Enumeration Date | 10/02/2008 |
| Last Update Date | 10/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447401971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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