| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2000 North Ave, Northfield, Minnesota |
| Authorized Official Name and Position | Eric Guth (CFO) |
| Authorized Official Contact | 5076461416 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2000 North Ave Northfield MN 55057 Ph: (507) 646-1000 | 2000 North Ave Northfield MN 55057 Ph: (507) 646-1494 |
| NPI Number | 1255367629 |
|---|---|
| Provider Enumeration Date | 06/25/2006 |
| Last Update Date | 12/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255367629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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