Provax LLC
NPI #1619202934 in Chanhassen, Minnesota
Provider Information
- NPI Number
- 1619202934
- Entity Type
- Organization
- Organization Name
- Provax LLC
- Primary Specialty
- Clinic/Center - Community Health
- Enumeration Date
- Oct 5, 2009
- Last Updated
- Oct 5, 2009
Practice Location
- Address
- 2018 STONE CREEK DR
- City
- Chanhassen
- State
- Minnesota
- ZIP Code
- 55317-7410
- Phone
- (952) 470-6005
Authorized Official
- Name
- MRS. CINDY L EGELSTON, R.N.
- Title
- OWNER
- Phone
- (952) 470-6005
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Community Health — Community Health |
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