Healthcare Provider Details
I. General information
NPI: 1720465636
Provider Name (Legal Business Name): RECOVERY PARTNERS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2015
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
950 6TH AVE N
NAPLES FL
34102-5633
US
IV. Provider business mailing address
15251 PLEASANT VALLEY RD PO BOX 11
CENTER CITY MN
55012-9640
US
V. Phone/Fax
- Phone: 651-213-4286
- Fax: 651-213-4543
- Phone: 651-213-4286
- Fax: 651-213-4543
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARVIN
SEPPALA
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 651-213-4825