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General NPI Number Information
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NPI Number | 1104587765
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Entity Type | Organization
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Legal Business Name | MAYO COLLABORATIVE SERVICES, INC
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 4001 41ST ST NW
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City | ROCHESTER
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State | MN
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Zip | 55901-8901
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Country | US
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Telephone | 800-447-6424
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4100
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City | ROCHESTER
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State | MN
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Zip | 55903-4100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DENNIS EUGENE DAHLEN
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Credential |
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Telephone | 507-266-4416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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