Mankato Clinic Ltd

NPI #1952576126 in Saint Peter, Minnesota

Provider Information

NPI Number
1952576126
Entity Type
Organization
Organization Name
Mankato Clinic Ltd
Subpart
Yes (part of a larger organization)
Parent Organization
MEDVANTX, INC.
Primary Specialty
Non-Pharmacy Dispensing Site
Enumeration Date
Apr 28, 2008
Last Updated
Oct 22, 2012

Practice Location

Address
1901 OLD MINNESOTA AVE
ZIP Code
56082-1763
Phone
(507) 934-2325

Authorized Official

Name
KENNY HEINE
Title
DIRECTOR OF OPERATIONS
Phone
(858) 625-2990

Specialties & Taxonomy Codes

Specialty
Non-Pharmacy Dispensing Site

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