| |
600 E Park Ave Ste 2, Olivia, MN 56277-1370 | |
(320) 523-3435 | |
(320) 323-4374 |
Full Name | |
---|---|
Type | Facility |
Speciality | Audiologist |
Location | 600 E Park Ave Ste 2, Olivia, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689086167 | NPI | - | NPPES |
1619303682 | Other | MN | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | 9024 (Minnesota) | Primary |
Provider Name | Rebecca M Thiesse |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1619303682 PECOS PAC ID: 7416187752 Enrollment ID: I20140305001680 |
Mailing Address | Practice Location Address |
---|---|
611 E Fairview Ave, Olivia, MN 56277-4213 Ph: (320) 523-1085 | 600 E Park Ave Ste 2, Olivia, MN 56277-1370 Ph: (320) 523-3435 |
Rebecca M Thiesse, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 600 E Park Ave, Ste 2, Olivia, MN 56277 Phone: 320-523-3435 Fax: 320-323-4374 |