RANDALL R POTTEBAUM

BURNSVILLE, MN
NPI1528042223
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103T00000X Psychologist
(Licence: MN  55)
Enumeration Date2005-12-06
Last Update Date2007-07-08
Business Address
-- RANDALL R POTTEBAUM
14000 FAIRVIEW DR PARK NICOLLET CLINIC BURNSVILLE
BURNSVILLE, MN 55337-5713
Phone number: 952-993-8608
Mailing Address
-- RANDALL R POTTEBAUM
6465 WAYZATA BLVD STE 315
ST LOUIS PARK, MN 55426-1728
Phone number: 952-993-6450
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