MARK S MELLSTROM MD PA
Organization (NPI-2)
Active
Clinic/Center, Primary Care
Provider Information
- NPI Number
1629244686- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 20157 ICENIC TRAIL, LAKEVILLE, MN, 55044
- Phone
- (952) 469-3393
- Fax
- (952) 469-3399
Specialties & Taxonomies
Clinic/Center, Primary Care
Primary License: MN #6208286