Organization Name: | THE INSTITUTE FOR EXERCISE MEDICINE AND PREVENTION |
NPI Number: | 1063659647 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CYNTHIA LYNN GARR (CEO) |
Mailing Address: | 2935 Country Dr Suite 103 Saint Paul |
State: | MN US |
Postal Code: | 551171183 |
Phone Number: | 6516052320 |
Fax Number: | |
NPI Enumeration Date: | 01/19/2009 |
NPI Last Update Date: | 01/19/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 33524 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |