Bloomington Lake Clinic, Ltd
NPI #1215090501 in Bloomington, Minnesota
Provider Information
- NPI Number
- 1215090501
- Entity Type
- Organization
- Organization Name
- Bloomington Lake Clinic, Ltd
- Primary Specialty
- Clinic/Center - Multi-Specialty
- Enumeration Date
- Dec 18, 2006
- Last Updated
- Apr 4, 2011
Practice Location
- Address
- 7901 XERXES AVE S STE 116
- City
- Bloomington
- State
- Minnesota
- ZIP Code
- 55431-1200
- Phone
- (952) 888-2024
Authorized Official
- Name
- DEBRA J BARGER
- Title
- ASSISTANT ADMINISTRATOR
- Phone
- (612) 277-2165
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Multi-Specialty — Multi-Specialty |
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