Provider Demographics
NPI:1386383693
Name:RVISION HEALTH PC
Entity type:Organization
Organization Name:RVISION HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:MESNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-670-4265
Mailing Address - Street 1:6055 NATHAN LANE N SUITE 200
Mailing Address - Street 2:ATTN: ANNE FROISTAD
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55442
Mailing Address - Country:US
Mailing Address - Phone:763-513-4377
Mailing Address - Fax:763-248-7565
Practice Address - Street 1:6055 NATHAN LN N STE 200
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55442-1675
Practice Address - Country:US
Practice Address - Phone:763-513-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care