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1861070948
REID KENNETH MIMMACK
MINNEAPOLIS, MN
NPI
1861070948
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-03-31
Last Update Date
2021-03-31
Business Address
REID KENNETH MIMMACK MD
701 PARK AVE
MINNEAPOLIS, MN 55415-1623
Phone number: 612-873-3000
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Mailing Address
REID KENNETH MIMMACK MD
638 POLK ST NE APT 1
MINNEAPOLIS, MN 55413-2439
Phone number: 218-330-4969
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