Healthcare Provider Details

I. General information

NPI: 1821057548
Provider Name (Legal Business Name): RODNEY W HELM RODNEY HELM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 PLEASANT AVE S
PARK RAPIDS MN
56470-1417
US

IV. Provider business mailing address

206 PLEASANT AVE S
PARK RAPIDS MN
56470-1417
US

V. Phone/Fax

Practice location:
  • Phone: 218-732-3389
  • Fax: 218-732-5994
Mailing address:
  • Phone: 218-732-3389
  • Fax: 218-732-5994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1540
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: