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General NPI Number Information
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NPI Number | 1598332009
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Entity Type | Individual
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Provider Name | ERIC PRESSLEY RT (R)
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Gender | Male
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 881 MEANDER CT
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City | MEDINA
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State | MN
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Zip | 55340-4549
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Country | US
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Telephone | 763-560-0010
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Fax |
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Provider Business Mailing Address
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Address Line | 1255 NORTHLAND DR
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City | SAINT PAUL
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State | MN
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Zip | 55120-1139
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Country | US
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Telephone | 651-687-0048
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | 312664
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License Number State |
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