Healthcare Provider Details

I. General information

NPI: 1588872071
Provider Name (Legal Business Name): GRAPHICA MEDICA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 01/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 S BROADWAY
ROCHESTER MN
55904-6505
US

IV. Provider business mailing address

328 S BROADWAY
ROCHESTER MN
55904-6505
US

V. Phone/Fax

Practice location:
  • Phone: 507-288-3354
  • Fax: 507-288-3431
Mailing address:
  • Phone: 507-288-3354
  • Fax: 507-288-3431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code229N00000X
TaxonomyAnaplastologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. GILLIAN F DUNCAN
Title or Position: PRESIDENT
Credential: B.F.A., M.S.
Phone: 507-288-3354