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366 E George St Ivanhoe MN 56142-9707 | |
| (507) 694-1100 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 366 E George St, Ivanhoe, Minnesota |
| Authorized Official Name and Position | Tabb Mccluskey (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5072752295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
366 E George St Po Box 43 Ivanhoe MN 56142-9707 Ph: (507) 694-1100 | 366 E George St Ivanhoe MN 56142-9707 Ph: (507) 694-1100 |
| NPI Number | 1376760777 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 11/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376760777 | NPI | - | NPPES |
| 232816000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1757969 (Minnesota) | Primary |
Ivanhoe Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 W Saxon St, Ivanhoe, MN 56142 Phone: 507-694-1232 Fax: 507-694-1171 | |