NPI Provider: 1164428223
Contact Name: Varecka F. Thomas
Position: president
Phone: (763) 383-0770
Wayzata Orthopedic’s P.a. Information:
Wayzata Orthopedic’s P.a. organization have npi 1164428223, taxonomy code is 207X00000X with license number is 22452 in . This Business address located in 2805 Campus Drive, Plymouth, MN 55441 Minnesota.
Practice Location
Address: 2805 Campus Dr, Plymouth, MN 55441
Phone: (763) 383-0770
Business Location
Address: 2805 Campus Drive, Plymouth, MN 55441
Phone: (763) 383-0770
Fax: (763) 383-0777
Taxonomy
Taxonomy Code: 207X00000X
License Number: 22452
License Number of State: MN
Primary Taxonomy Switch: Y
Enumeration Date: 6/23/2005
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