Healthcare Provider Details

I. General information

NPI: 1194725044
Provider Name (Legal Business Name): ARROWHEAD CONSULTATION SERVICE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 SE 13TH ST SUITE 101
GRAND RAPIDS MN
55744-4248
US

IV. Provider business mailing address

415 SE 13TH ST SUITE 101
GRAND RAPIDS MN
55744-4248
US

V. Phone/Fax

Practice location:
  • Phone: 218-326-5424
  • Fax: 218-327-4930
Mailing address:
  • Phone: 218-326-5424
  • Fax: 218-327-4930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL NORMAN OLSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 218-326-5424