Columbia Park Medical Group, PA

NPI #1619077575 in Columbia Heights, Minnesota

Provider Information

NPI Number: 1619077575
Entity Type: Organization
Organization Name: Columbia Park Medical Group, PA
Primary Specialty: Eyewear Supplier
Enumeration Date: Sep 22, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 4000 CENTRAL AVE NE
City: Columbia Heights
State: Minnesota
ZIP Code: 55421-2968
Phone: (763) 572-5710

Authorized Official

Name: JOHN LOUIS WEIR
Title: EXECUTIVE DIRECTOR
Phone: (763) 586-5877

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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