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General NPI Number Information
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NPI Number | 1699882548
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Entity Type | Organization
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Legal Business Name | METRO FIRST ASSISTANTS, INC.
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5130 HOLLY LN N UNIT 3
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City | PLYMOUTH
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State | MN
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Zip | 55446-1773
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Country | US
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Telephone | 763-694-9248
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Fax | 763-694-0293
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Provider Business Mailing Address
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Address Line | 5130 HOLLY LN N UNIT 3
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City | PLYMOUTH
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State | MN
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Zip | 55446-1773
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Country | US
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Telephone | 763-694-9248
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Fax | 763-694-0293
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Authorized Official
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Title or Position | LICENSED SURGICAL ASSISTANT
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Name | MR. BRUCE EDWARD HERTZENBERG
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Credential | CST/CFA/LSA
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Telephone | 763-694-9248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | SA00271
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License Number State | TX
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