Healthcare Provider Details

I. General information

NPI: 1699882548
Provider Name (Legal Business Name): METRO FIRST ASSISTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 HOLLY LN N UNIT 3
PLYMOUTH MN
55446-1773
US

IV. Provider business mailing address

5130 HOLLY LN N UNIT 3
PLYMOUTH MN
55446-1773
US

V. Phone/Fax

Practice location:
  • Phone: 763-694-9248
  • Fax: 763-694-0293
Mailing address:
  • Phone: 763-694-9248
  • Fax: 763-694-0293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License NumberSA00271
License Number StateTX

VIII. Authorized Official

Name: MR. BRUCE EDWARD HERTZENBERG
Title or Position: LICENSED SURGICAL ASSISTANT
Credential: CST/CFA/LSA
Phone: 763-694-9248