Organization Name: | ASPEN MEDICAL GROUP, PA |
NPI Number: | 1407806243 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TOM MATENAER (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 1021 Bandana Blvd E Suite 200 Saint Paul |
State: | MN US |
Postal Code: | 551085113 |
Phone Number: | 6516372922 |
Fax Number: | 6516372974 |
NPI Enumeration Date: | 05/11/2006 |
NPI Last Update Date: | 03/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |