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General NPI Number Information
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NPI Number | 1215161799
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Entity Type | Individual
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Provider Name | GARY M SALMELA
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Gender | Male
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 26 SOUTH
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City | SOUDAN
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State | MN
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Zip | 55782-0392
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Country | US
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Telephone | 218-753-6310
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Fax |
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Provider Business Mailing Address
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Address Line | 26 SOUTH PO BOX 392
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City | SOUDAN
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State | MN
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Zip | 55782-0392
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Country | US
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Telephone | 218-753-6310
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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