Healthcare Provider Details

I. General information

NPI: 1033055397
Provider Name (Legal Business Name): THE DULUTH CLINIC, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 HIGHWAY 33 S STE 1102
CLOQUET MN
55720-2626
US

IV. Provider business mailing address

1413 HIGHWAY 33 S STE 1102
CLOQUET MN
55720-2626
US

V. Phone/Fax

Practice location:
  • Phone: 218-337-4890
  • Fax: 218-337-6893
Mailing address:
  • Phone: 218-337-4890
  • Fax: 218-337-6893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KEVIN BOREN
Title or Position: VP OF FINANCE
Credential:
Phone: 218-786-1009