| Bureau Of Prisons | |
|
4464 Ralston Dr Duluth MN 55811-1519 | |
| (218) 249-7452 | |
| Not Available |
| Full Name | Bureau Of Prisons |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4464 Ralston Dr, Duluth, Minnesota |
| Authorized Official Name and Position | Traci Sue Amundson (CHIEF PSYCHOLOGIST) |
| Authorized Official Contact | 2182497452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bureau Of Prisons 4464 Ralston Drive Duluth MN 55811-1519 Ph: (218) 249-7452 | Bureau Of Prisons 4464 Ralston Dr Duluth MN 55811-1519 Ph: (218) 249-7452 |
| NPI Number | 1982971271 |
|---|---|
| Provider Enumeration Date | 11/30/2011 |
| Last Update Date | 11/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982971271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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