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General NPI Number Information
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NPI Number | 1295084309
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY PREVENTION, LLC
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 2800 CAMPUS DR STE 44
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City | PLYMOUTH
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State | MN
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Zip | 55441-2669
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Country | US
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Telephone | 612-913-9758
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Fax |
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Provider Business Mailing Address
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Address Line | 333 WASHINGTON AVE N FL 3
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City | MINNEAPOLIS
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State | MN
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Zip | 55401-2263
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Country | US
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Telephone | 612-444-3174
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Fax |
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Authorized Official
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Title or Position | DIR OF OPERATIONS
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Name | THOMAS BREGMANN
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Credential |
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Telephone | 612-386-8685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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