Wayzata Children's Clinic P.a.

NPI #1023081577 in Minnetonka, Minnesota

Provider Information

NPI Number: 1023081577
Entity Type: Organization
Organization Name: Wayzata Children's Clinic P.a.
Primary Specialty: Pediatrics
Enumeration Date: Feb 7, 2006
Last Updated: Apr 5, 2017

Practice Location

Address: 14001 RIDGEDALE DR
Address 2: #100
City: Minnetonka
State: Minnesota
ZIP Code: 55305-1753
Phone: (952) 473-0211

Authorized Official

Name: MARTHA R. ENGELBREKT, MD
Title: PRESIDENT
Phone: (952) 473-0211

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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