Provider Demographics
NPI:1407337629
Name:WOODBURY PROGRESSIVE MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:WOODBURY PROGRESSIVE MEDICAL ASSOCIATES PC
Other - Org Name:HEALTHMAX PROGRESSIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:DREWS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-735-8646
Mailing Address - Street 1:7060 VALLEY CREEK PLZ STE 121
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2269
Mailing Address - Country:US
Mailing Address - Phone:651-735-8646
Mailing Address - Fax:651-730-9210
Practice Address - Street 1:7060 VALLEY CREEK PLZ STE 121
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2269
Practice Address - Country:US
Practice Address - Phone:651-735-8646
Practice Address - Fax:651-730-9210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-25
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty