Healthcare Provider Details

I. General information

NPI: 1710129739
Provider Name (Legal Business Name): MACPHAIL CENTER FOR MUSIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 05/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S 2ND ST
MINNEAPOLIS MN
55401-2383
US

IV. Provider business mailing address

501 S 2ND ST
MINNEAPOLIS MN
55401-2383
US

V. Phone/Fax

Practice location:
  • Phone: 612-321-0100
  • Fax: 612-333-1666
Mailing address:
  • Phone: 612-321-0100
  • Fax: 612-333-1666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: PAUL BABCOCK
Title or Position: PRESIDENT
Credential:
Phone: 612-321-0100