Sage Prairie Laboratory
NPI #1164089447 in Eagan, Minnesota
Provider Information
- NPI Number
- 1164089447
- Entity Type
- Organization
- Organization Name
- Sage Prairie Laboratory
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MEDICAL ADDICTION TREATMENT CLINIC
- Primary Specialty
- Specialist/Technologist, Other
- Enumeration Date
- May 22, 2019
- Last Updated
- May 22, 2019
Practice Location
Authorized Official
- Name
- GRANT ARNOLD PYLKAS, MMA
- Title
- EXECUTIVE DIRECTOR
- Phone
- (651) 238-5558
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist, Other |
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