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1871240267
DIVINE HEALTH LLC
SAINT PAUL, MN
NPI
1871240267
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Entity Type
Organization
Authorized Contact
VICTOR T DAVIS
Co Owner
952-288-9921
Organization Subpart ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
Enumeration Date
2022-03-04
Last Update Date
2022-03-04
Business Address
DIVINE HEALTH LLC
625 SNELLING AVE N STE A-2
SAINT PAUL, MN 55104-2878
Phone number: 952-288-9921
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Mailing Address
DIVINE HEALTH LLC
625 SNELLING AVE N STE A-2
SAINT PAUL, MN 55104-2878
Phone number: 952-288-9921
Copy
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