| Organization Name: | NORTH CLINIC, PA |
| NPI Number: | 1114962206 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SCOTT R COLSON (PRESIDENT) |
| Mailing Address: | 9201 W Broadway Ave Suite 601 Brooklyn Park |
| State: | MN US |
| Postal Code: | 554451923 |
| Phone Number: | 7635877900 |
| Fax Number: | 7635877066 |
| NPI Enumeration Date: | 06/20/2006 |
| NPI Last Update Date: | 07/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207KA0200X |
| License Number: | 123 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Allergy & Immunology |
| Taxonomy Specialization: | Allergy |
| Taxonomy Definition: | |