| NPI | 1225158520 |
|---|---|
| Former Legal Business Name | FRIDLEY CHILDREN'S AND TEENAGERS' MEDICAL CENTER PA |
| Entity Type | Organization |
| Authorized Contact | ANGELA MARIE BENNETT Practic Administrator 763-333-7755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2021-08-24 |