Healthcare Provider Details

I. General information

NPI: 1235455221
Provider Name (Legal Business Name): LVH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7372 WOIDA RD
BAXTER MN
56425-8564
US

IV. Provider business mailing address

7372 WOIDA RD
BAXTER MN
56425-8564
US

V. Phone/Fax

Practice location:
  • Phone: 218-829-1709
  • Fax: 218-829-8187
Mailing address:
  • Phone: 218-829-1709
  • Fax: 218-829-8187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBORAH ELIZABETH EBERTS
Title or Position: DVM/OWNER
Credential: DVM
Phone: 218-829-1709