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117 N Main St Mahnomen MN 56557-4003 | |
(218) 936-5616 | |
(218) 936-5619 |
Full Name | |
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Speciality | Family Medicine |
Location | 117 N Main St, Mahnomen, Minnesota |
Authorized Official Name and Position | Larry G Solberg (ADMINISTRATOR-AUTHORIZED OFFICIAL) |
Authorized Official Contact | 7013643405 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 727 Detroit Lakes MN 56502-0727 Ph: (218) 844-2300 | 117 N Main St Mahnomen MN 56557-4003 Ph: (218) 936-5616 |
NPI Number | 1215988894 |
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Provider Enumeration Date | 05/16/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1215988894 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |