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12535 Hillside Ln Se Becker MN 55308-8810 | |
(320) 420-0254 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 12535 Hillside Ln Se, Becker, Minnesota |
Authorized Official Name and Position | Timothy Joseph Montag (PRESIDENT) |
Authorized Official Contact | 3204200254 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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12535 Hillside Ln Se Becker MN 55308-8810 Ph: (320) 420-0254 | 12535 Hillside Ln Se Becker MN 55308-8810 Ph: (320) 420-0254 |
NPI Number | 1962640235 |
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Provider Enumeration Date | 01/26/2009 |
Last Update Date | 01/26/2009 |
Identifier | Type | State | Issuer |
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1962640235 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (Minnesota) | Primary |