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232 Hwy 78 N Ottertail MN 56571-0129 | |
(218) 367-6262 | |
(218) 367-6266 |
Full Name | |
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Speciality | Clinic/Center |
Location | 232 Hwy 78 N, Ottertail, Minnesota |
Authorized Official Name and Position | Joel Beiswenger (CEO) |
Authorized Official Contact | 2183617483 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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415 Jefferson St N Wadena MN 56482-1264 Ph: (218) 631-7501 | 232 Hwy 78 N Ottertail MN 56571-0129 Ph: (218) 367-6262 |
NPI Number | 1871546663 |
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Provider Enumeration Date | 05/19/2006 |
Last Update Date | 02/03/2023 |
Medicare PECOS PAC ID | 2961395272 |
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Medicare Enrollment ID | O20090818000796 |
Identifier | Type | State | Issuer |
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1871546663 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |