Healthcare Provider Details
I. General information
NPI: 1356597272
Provider Name (Legal Business Name): TWIN CITIES OCCUPATIONAL HEALTH & REHAB
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2008
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10190 BALTIMORE ST NE SUITE 100
BLAINE MN
55449-5056
US
IV. Provider business mailing address
2520 PILOT KNOB RD #250
MENDOTA HEIGHTS MN
55120-1137
US
V. Phone/Fax
- Phone: 763-780-8264
- Fax: 763-780-8274
- Phone: 651-224-8264
- Fax: 651-224-8265
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ROBERT
H
SEEDS
Title or Position: CEO
Credential:
Phone: 651-224-8264