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Good Clinic Mn PLLC

Non-Pharmacy Dispensing Site in Minneapolis, MN. Organization (NPI-2).

NPI number1962097683
StatusActive
Last updated in NPPESMar 4, 2021

Details

NPI
1962097683
Entity type
Organization (NPI-2)
Legal business name
Good Clinic Mn PLLC
Organization subpart
No
Enumeration date
Mar 4, 2021
Certification date
Feb 11, 2021
Last updated
Mar 4, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332900000X Non-Pharmacy Dispensing Site––Yes

Practice location

307 1st Avenue
Minneapolis, MN 55413-0000

Phone 952-653-2525 · Fax 952-653-2540

Mailing address

307 1st Avenue
Minneapolis, MN 55413

Phone 952-653-2525 · Fax 952-653-2540

Authorized official

Rebecca Hafner-Fogarty
Authorized Official
6122848206

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