Sand Pine Pheasants Family Recreation LLC

NPI #1225675739 in Avon, Minnesota

Provider Information

NPI Number: 1225675739
Entity Type: Organization
Organization Name: Sand Pine Pheasants Family Recreation LLC
Primary Specialty: Durable Medical Equipment & Medical Supplies
Enumeration Date: Dec 3, 2019
Last Updated: Dec 3, 2019

Practice Location

Address: 12195 NORWAY RD
City: Avon
State: Minnesota
ZIP Code: 56310-4502
Phone: (320) 363-4790

Authorized Official

Name: MR. KEITH JOSEPH SAND
Title: OWNER
Phone: (320) 363-4790

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	Primary

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