Itasca Surgical Clinic, Pa

NPI 1245288984 - Specialist - 174400000X

NPI Details
NPI 1245288984
Enumeration Date 05/05/2006
Last Updated 07/09/2009
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name DANIEL DANIEL
Position OWNER
Phone (218) 327-7973
Fax (218) 327-3245
Practice Location
1542 GOLF COURSE RD
SUITE 202
GRAND RAPIDS MN, 55744-9603, US
Phone (218) 327-7973
Fax (218) 327-3245
Business Location
3920 13TH AVE E
SUITE 6
HIBBING MN, 55746-3675, US
Phone (218) 263-7540
Fax (866) 732-0699
Toxanomy
Taxonomy Code 174400000X
License State
License Number
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According to our database, Itasca Surgical Clinic, Pa NPI is 1245288984, taxonomy code is 174400000X Itasca Surgical Clinic, Pa physically located at 1542 Golf Course Rd, Grand Rapids MN, 55744-9603. NPI Number 1033115704 has the healthcare provider type.

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1245288984 NPI number is provided on an as is basis without warranty of any kind. 1245288984 is maintained by the National Plan & Provider Enumeration System. The contents of Itasca Surgical Clinic, Pa are for informational purposes only.