Healthcare Provider Details

I. General information

NPI: 1316098445
Provider Name (Legal Business Name): IRON RANGE REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 10/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 9TH ST N SUITE 100
VIRGINIA MN
55792-2279
US

IV. Provider business mailing address

901 9TH ST N SUITE 100
VIRGINIA MN
55792-2279
US

V. Phone/Fax

Practice location:
  • Phone: 218-749-9405
  • Fax: 218-749-9407
Mailing address:
  • Phone: 218-749-9405
  • Fax: 218-749-9407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW ELLIOTT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 218-749-9405