Provider Demographics
NPI:1285222323
Name:MINNESOTA PROFESSIONAL READING PC
Entity type:Organization
Organization Name:MINNESOTA PROFESSIONAL READING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEV
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-287-3093
Mailing Address - Street 1:DEPT 1137
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74182-0001
Mailing Address - Country:US
Mailing Address - Phone:720-287-3093
Mailing Address - Fax:888-851-3671
Practice Address - Street 1:DEPT 1137
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74182-0001
Practice Address - Country:US
Practice Address - Phone:720-287-3093
Practice Address - Fax:888-851-3671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty