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General NPI Number Information
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NPI Number | 1285911750
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Entity Type | Organization
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Legal Business Name | MINNETONKA PUBLIC SCHOOLS
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 5621 COUNTY ROAD 101
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City | MINNETONKA
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State | MN
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Zip | 55345-4214
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Country | US
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Telephone | 952-401-5017
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Fax | 952-401-5032
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Provider Business Mailing Address
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Address Line | 5621 COUNTY ROAD 101
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City | MINNETONKA
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State | MN
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Zip | 55345-4214
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Country | US
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Telephone | 952-401-5017
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Fax | 952-401-5032
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR OF STUDENT SUPPO
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Name | DR. JAN R BOOTSMA
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Credential | PH.D.
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Telephone | 952-401-5017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | MN
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