Palliative Providers, PA
NPI #1952181935 in White Bear Lake, Minnesota
Provider Information
- NPI Number
- 1952181935
- Entity Type
- Organization
- Organization Name
- Palliative Providers, PA
- Primary Specialty
- Hospice Care, Community Based
- Enumeration Date
- Oct 5, 2023
- Last Updated
- Oct 5, 2023
Practice Location
- Address
- 4707 HIGHWAY 61 N STE 116
- City
- White Bear Lake
- State
- Minnesota
- ZIP Code
- 55110-3227
- Phone
- (651) 247-4727
Authorized Official
- Name
- THOMAS V SOUKUP, DO
- Title
- PHYSICIAN
- Phone
- (651) 247-4727
Specialties & Taxonomy Codes
| Specialty |
|---|
| Hospice Care, Community Based |
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