Graduated: 2021
NPI: 1033592472
Practice Locations (3)
PARK NICOLLET CLINIC
5320 HYLAND GREENS DR
BLOOMINGTON, MN 554373934
9529932400
TRIA ORTHOPAEDIC CENTER LLC
8100 NORTHLAND DR
BLOOMINGTON, MN 554314800
9528318742
PARK NICOLLET CLINIC
2001 BLAISDELL AVE
MINNEAPOLIS, MN 554042414
9529938000
Source: CMS National Downloadable File, September 2026.