Avanti Medical Group of Minnesota LLC
NPI #1578872974 in Stillwater, Minnesota
Provider Information
- NPI Number
- 1578872974
- Entity Type
- Organization
- Organization Name
- Avanti Medical Group of Minnesota LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- AVANTI MEDICAL GROUP
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Oct 2, 2010
- Last Updated
- Oct 2, 2010
Practice Location
- Address
- 1801 MARKET DR
- City
- Stillwater
- State
- Minnesota
- ZIP Code
- 55082-7599
- Phone
- (318) 465-5874
Authorized Official
- Name
- AMY GRAHAM, RN, BSN
- Title
- VICE PRESIDENT MEDICAL AFFAIRS
- Phone
- (318) 465-5874
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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