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1000 E 1st St Ste 105 Duluth MN 55805-2297 | |
(218) 722-1122 | |
(218) 722-0600 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 1000 E 1st St Ste 105, Duluth, Minnesota |
Authorized Official Name and Position | Adam James Ries (CLINICAL PSYCHOLOGIST, CEO) |
Authorized Official Contact | 6129109919 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5433 Lakewood Rd Duluth MN 55804-9720 Ph: (612) 910-9919 | 1000 E 1st St Ste 105 Duluth MN 55805-2297 Ph: (218) 722-1122 |
NPI Number | 1073005856 |
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Provider Enumeration Date | 06/06/2018 |
Last Update Date | 06/06/2018 |
Identifier | Type | State | Issuer |
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1073005856 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | LP5778 (Minnesota) | Primary |
Lake Superior Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4602 Grand Ave Ste 1000, Duluth, MN 55807 Phone: 218-336-3520 Fax: 218-624-6097 | |
St. Luke's Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 915 E 1st St, Duluth, MN 55805 Phone: 218-249-5232 | |
Mission Creek Transitional Care Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 Marshall St, Duluth, MN 55803 Phone: 218-340-8674 |