SIMON HENRY LUETH

OAK PARK HEIGHTS, MN
NPI1215357108
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: MN  11596)
Additional Taxonomies363AS0400X Physician Assistant, Surgical
(Licence: WI  3312-23)
Enumeration Date2014-04-18
Last Update Date2015-07-01
Business Address
-- SIMON HENRY LUETH PAC
5803 NEAL AVE N
OAK PARK HEIGHTS, MN 55082-2177
Phone number: 651-439-8807
Mailing Address
-- SIMON HENRY LUETH PAC
5803 NEAL AVE N
OAK PARK HEIGHTS, MN 55082-2177
Phone number: 651-439-8807