Healthcare Provider Details

I. General information

NPI: 1689233900
Provider Name (Legal Business Name): PRACO CONTRACTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 06/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3837 GLENHURST AVE
ST LOUIS PARK MN
55416-4915
US

IV. Provider business mailing address

3837 GLENHURST AVE
ST LOUIS PARK MN
55416-4915
US

V. Phone/Fax

Practice location:
  • Phone: 612-226-0871
  • Fax:
Mailing address:
  • Phone: 612-226-0871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH WAYNE LIMRUC
Title or Position: MANAGER
Credential:
Phone: 651-428-2197