Graduated: 2019
NPI: 1306476189
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
3931 LOUISIANA AVE S
ST LOUIS PARK, MN 554265000
9529933123
Source: CMS National Downloadable File, September 2026.