MINOR MEDICAL SQUAD PLLC is a community health clinic center in St Louis Park, MN. MINOR MEDICAL SQUAD PLLC NPI is 1821646985. The provider is registered as an organization entity type.
The provider's business location address is:
5775 WAYZATA BLVD STE 700
ST LOUIS PARK, MN
ZIP 55416-233
Phone: (612) 504-6160
Fax: (855) 818-2050
The provider's authorized official is Michael Vito Dimucci .
The authorized official title is Owner, Family Nurse Practitioner and has the following contact phone number (612) 805-8676.
The CLIA number assigned to this NPI record is 24D2174558 - other practitioner with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 8/30/2019 and was last updated on 4/20/2021.