| Organization Name: | WAYZATA SURGERY CENTER |
| NPI Number: | 1134527880 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN ALLAN NESS (OWNER/ADMINISTRATOR) |
| Mailing Address: | 935 Wayzata Blvd E Ste 101 Wayzata |
| State: | MN US |
| Postal Code: | 553911849 |
| Phone Number: | 7635594500 |
| Fax Number: | 7635591733 |
| NPI Enumeration Date: | 12/11/2014 |
| NPI Last Update Date: | 12/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 369743 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |