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General NPI Number Information
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NPI Number | 1760905475
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Entity Type | Organization
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Legal Business Name | PATIENT CENTERED CARE
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/25/2017
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Provider Practice Location Address
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Address Line | 8240 HAMPSHIRE CT N
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City | BROOKLYN PARK
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State | MN
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Zip | 55445
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Country | US
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Telephone | 763-221-3293
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Fax |
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Provider Business Mailing Address
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Address Line | 8240 HAMPSHIRE CT N
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City | BROOKLYN PARK
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State | MN
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Zip | 55445-2539
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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 | MANAGER
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Name | KEHINDE NGW
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Credential |
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Telephone | 763-221-3293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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