| Jack V, Lundbohm Inc | |
|
317 2nd St Nw Suite A Roseau MN 56751-1070 | |
| (218) 463-2992 | |
| (218) 463-1229 |
| Full Name | Jack V, Lundbohm Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 317 2nd St Nw, Roseau, Minnesota |
| Authorized Official Name and Position | Jack V Lundbohm (PRESIDENT) |
| Authorized Official Contact | 2184632992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack V, Lundbohm Inc 317 2nd St Nw Suite A Roseau MN 56751-1070 Ph: (218) 463-2992 | Jack V, Lundbohm Inc 317 2nd St Nw Suite A Roseau MN 56751-1070 Ph: (218) 463-2992 |
| NPI Number | 1780822486 |
|---|---|
| Provider Enumeration Date | 02/03/2009 |
| Last Update Date | 02/03/2009 |
| Medicare PECOS PAC ID | 7113077504 |
|---|---|
| Medicare Enrollment ID | O20090605000084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780822486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1792 (Minnesota) | Primary |
| Provider Name | Jack V Lundbohm |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1275632234 PECOS PAC ID: 0749217974 Enrollment ID: I20050720000153 |
Lifecare Clinic Roseau Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 715 Delmore Dr, Ste 100, Roseau, MN 56751 Phone: 218-463-1365 | |
Altru Clinic - Roseau Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 711 Delmore Dr, Roseau, MN 56751 Phone: 218-463-1365 |