Healthcare Provider Details

I. General information

NPI: 1891972907
Provider Name (Legal Business Name): RIDGEVIEW CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 01/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W CHANDLER ST
ARLINGTON MN
55307-2127
US

IV. Provider business mailing address

601 W CHANDLER ST
ARLINGTON MN
55307-2127
US

V. Phone/Fax

Practice location:
  • Phone: 507-964-2271
  • Fax:
Mailing address:
  • Phone: 507-964-2271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number49463
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number20221
License Number StateMN

VIII. Authorized Official

Name: KRISTI BESSE
Title or Position: OPERATIONS & BUSINESS OFFICE MANAGE
Credential:
Phone: 952-442-7895