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Crystal Twynham Md Plc
Medical Specialty Clinic/Center in Maple Grove, Minnesota
NPI 1962707398

Crystal Twynham Md Plc is a Medical Specialty Clinic/Center based in Maple Grove, MN and is specialized in Medical Specialty. Crystal Twynham Md Plc practices in Maple Grove, MN. The NPI Number for Crystal Twynham Md Plc is 1962707398 and holds a License No. 39691 (Minnesota).

The current practice location address for Crystal Twynham Md Plc is 15552 68Th Pl N, Maple Grove, MN and can be reached out via phone at 931-237-2265 and via fax at 612-594-8998.

Location: 15552 68Th Pl N, Maple Grove, MN, 55311-3291
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1962707398
Provider Name
Crystal Twynham Md Plc
Credential
Provider Entity Type
Organization
Address
15552 68Th Pl N, Maple Grove, MN, 55311-3291
Phone Number
931-237-2265
Fax Number
612-594-8998
Provider Enumeration Date
01/15/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
514517100 05 MN
institution
Provider Business Practice Location Address Details
Address
15552 68Th Pl N
City
Maple Grove
State
Minnesota
Zip
55311-3291
Phone Number
931-237-2265
Fax Number
612-594-8998
person
Provider Business Mailing Address Details
Address
15552 68Th Pl N
City
Maple Grove
State
Minnesota
Zip
55311-3291
Phone Number
931-237-2265
Fax Number
612-594-8998
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
39691 (Minnesota)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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