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Elizabeth Fell Loken
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NPI Number Detailed Information
Provider Information:
| Name: | Elizabeth Fell Loken |
| Gender: | F |
| Provider License Number If Given: | 9806 |
NPI Information:
| NPI: | 1124012638 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 6/25/2013 |
Provider Business Mailing Address:
| Address: | 8170 33RD AVE S MS21110Q Minneapolis, MN 55425 |
| Phone Number: | 6513518180 |
| Fax Number: | 6513518179 |
Provider Business Practice Location Address:
| Address: | 5701 STILLWATER BLVD N Stillwater, MN 55082 |
| Phone Number: | 6513518180 |
| Fax Number: | 6513518179 |
Provider Taxonomy:
| Primary: | 363A00000X |
| Secondary (if any): | 363AM0700X |
| State: | MN |
